Numerical Simulation of Hemodynamic Changes in Central Veins after Tunneled Cuffed Central Venous Catheter Placement in Patients under Hemodialysis.
Numerical Simulation of Hemodynamic Changes in Central Veins after Tunneled Cuffed Central Venous Catheter Placement in Patients under Hemodialysis.
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血液透析患者放置隧道式套囊中心静脉导管后中央静脉血流动力学变化的数值模拟。
DOI：
10.1038/s41598-017-12456-7
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发表时间：
2017-11-21
影响因子：
4.6
通讯作者：
Li Z
中科院分区：
文献类型：
--
作者：
Peng L;Qiu Y;Huang Z;Xia C;Dai C;Zheng T;Li Z
隧道式中心静脉导管（CVC）在血液透析患者中发挥着重要作用，但CVC相关的中心静脉血栓形成仍然存在问题。本研究首次尝试用数值方法找出哪些血流动力学参数易导致CVC插入后血栓的发生和形成。探讨血流动力学参数与血栓发生率之间的潜在关系。结果表明，CVC的插入导致了水力阻力的显著增加，广泛的异常高壁剪切应力（WSS），以及静脉中流动旋转的巨大损失。此外，临床资料显示，血栓形成主要发生在CVC插入后血流失去螺旋旋转最多的部位，但血栓形成与血流速度和WSS没有对应关系。我们推测，中心静脉血流旋转的破坏是CVC周围血栓形成的前兆，CVC插入时引入螺旋血流可能有助于保护中心静脉不形成血栓。应该进行进一步的动物和临床实验来测试和验证这一推测。
The tunneled central venous catheter (CVC) plays an important role for hemodialysis patients, but CVC-related thrombosis in the central veins remain problematic. This study is the first try to numerically find out what hemodynamic parameters are predisposed to the initiation and formation of thrombus after CVC insertion. And the potential relationship between hemodynamic parameters and the incidence rates of thrombosis occurrence was explored. The results revealed that the CVC insertion led to a significant increase of hydraulic resistance, wide-ranging abnormally high wall shear stress (WSS), and a great loss of flow rotation in the vein. Moreover, the clinical data showed that thrombosis mainly occurred at sections where most blood flow lost spiral rotation after the CVC insertion, but no corresponding match was observed between the occurrence of thrombosis and the flow velocity or WSS. We speculate that the destruction of the flow rotation in the central vein is a precursor to the thrombus formation around CVC, and an introduction of spiral flow with the CVC insertion may possibly help to protect the central vein from thrombosis. Further animal and clinical experiments should be carried out to test and verify this speculation.
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影响因子：
6.1
作者：
Ene-Iordache, Bogdan;Remuzzi, Andrea
通讯作者：
Remuzzi, Andrea
动脉系统螺旋流的生理意义及其潜在的临床应用
影响因子：
3.8
作者：
Liu, Xiao;Sun, Anqiang;Deng, Xiaoyan
通讯作者：
Deng, Xiaoyan
影响因子：
2.9
作者：
Yardim, Hasan;Erkoc, Reha;Avcu, Serhat
通讯作者：
Avcu, Serhat
DOI：
10.1161/01.atv.0000229658.76797.30
发表时间：
2006-08-01
影响因子：
8.7
作者：
Hathcock, James J.
通讯作者：
Hathcock, James J.
DOI：
10.5455/msm.2015.27.112-113
发表时间：
2015-04-01
期刊：
Materia socio-medica
影响因子：
--
作者：
Misanovic, Verica;Jonuzi, Fedzat;Rahmanovic, Samra
通讯作者：
Rahmanovic, Samra