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PubMed1984

Turbulence in pulsatile flows.

Turbulence during pulsatile flow has been suggested as a possible mechanism to enhance the transport of gases during high-frequency ventilation. Experimental studies on oscillatory flow in straight, circular tubes have identified three types of flow: (a) laminar; (b) conditionally turbulent, in which high-frequency disturbances occur during the decelerating phase of the flow cycle but relaminarize by the beginning of the subsequent accelerating phase; and (c) fully turbulent flow, in which disturbances occur throughout the flow cycle. Fully turbulent flow has been observed only when a mean flow is present, and only laminar or conditionally turbulent flow has been observed for purely oscillatory flow. A critical Reynolds number based on the Stokes layer can be defined, and transition Reynolds numbers between 400 and 550 have been experimentally determined for purely oscillatory flow in a circular tube, although lower values are expected for physiological flows. There are some indications that the structure of oscillating turbulent flow is similar to steady turbulent flow, and preliminary work in our laboratory shows that the spectral content of flows during high-frequency ventilation is similar to that in steady turbulent flow.

Animals↗
PubMed1989

Pressure drop and flow rate measurements in a human aortic bifurcation cast for steady and pulsatile flow.

Pressure drop and flow rate measurements in a rigid cast of a human aortic bifurcation under both steady and physiological pulsatile flow conditions are reported. Integral momentum and mechanical energy balances are used to calculate impedance, spatially averaged wall shear stress and viscous dissipation rate from the data. In the daughter branches, steady flow impedance is within 30% of the Poiseuille flow prediction, while pulsatile flow impedance is within a factor of 2 of fully developed, oscillatory, straight tube flow theory (Womersley theory). Estimates of wall shear stress are in accord with measurements obtained from velocity profiles. Mean pressure drop and viscous dissipation rate are elevated in pulsatile flow relative to steady flow at the mean flow rate, and the exponents of their Reynolds number dependence are in accord with available theory.

Aged↗
PubMed1995

Nature of flow acceleration into a finite-sized orifice: steady and pulsatile flow studies on the flow convergence region using simultaneous ultrasound Doppler flow mapping and laser Doppler velocimetry.

OBJECTIVES: This study investigated the proximal centerline flow convergence region simultaneously by both color Doppler and laser Doppler velocimetry. BACKGROUND: Although numerous investigations have been performed to test the flow convergence method, to our knowledge there has yet been no experimental study using reference standard velocimetric techniques to define precisely the hydrodynamic factors involved in the accelerating flow region during steady and pulsatile flow. METHODS: Using an in vitro model that allows velocity measurements by laser Doppler velocimetry with simultaneous comparison with color Doppler results, we studied the centerline flow acceleration region proximal to orifices of various sizes (0.08 to 2.0 cm2). RESULTS: Agreement between theory and experimental velocities was good for large flow rates through small orifices only, and only at distances > 1.2 cm from the orifice. Changing the orifice shape from circular to slitlike produced no significant changes in velocity profiles. Constraining the proximal side walls caused a significant increase in proximal velocities at distances > 0.7 cm for the largest orifice only (2.0 cm2). Calculated flow rates agreed well with actual flow rates, with functional dependence on proximal distance and orifice size. Velocity profiles for pulsatile flow were similar to steady state flow profiles and could be integrated to calculate stroke volumes, which followed actual flow volumes well, although with general overestimation (y = 1.22x + 0.164, r = 0.92), most likely due to the use of all available proximal velocities. CONCLUSIONS: The accelerating proximal flow region responds to several hydrodynamic factors that can affect flow quantitation using the flow convergence method in the clinical situation.

Blood Flow Velocity↗
PubMed1983

Prevention and reperfusion injury following cardioplegic arrest by pulsatile flow.

To assess the efficacy of pulsatile flow in minimizing reperfusion injury following cardioplegic arrest, 20 dogs supported by cardiopulmonary bypass underwent 60 minutes of hypothermic, hyperkalemic crystalloid cardioplegic arrest. The effects of pulsatile flow (Group 2), initiated during 30 minutes of reperfusion, on myocardial adenosine triphosphate (ATP) and creatine phosphate (CP) stores, coronary blood flow, and myocardial water content were compared with the effects of linear flow reperfusion (Group 1). Myocardial ATP stores were maintained at preischemic levels by this mode of myocardial protection. However, pulsatile flow prevented the significant decline in ATP levels incurred during linear reperfusion. Creatine phosphate stores, although depleted during arrest, were restored equally, regardless of the mode of reperfusion. The decline in ATP stores was associated with no pathological increase in myocardial water content, but was associated with persistent reactive hyperemia. In contrast, after 30 minutes of pulsatile reperfusion, coronary blood flow was significantly decreased compared with preischemic flow. These data indicate that pulsatile reperfusion can prevent the unique decline in ATP levels associated with the restoration of coronary flow after cardioplegic arrest (reperfusion injury), and support its continuing evaluation as an adjunct to adequate intraoperative myocardial protection.

Adenosine Triphosphate↗
PubMed1979

Does pulsatile flow influence the incidence of postoperative hypertension?

Twenty patients undergoing primary elective aorta--coronary artery bypass were divided into two equal groups, both receiving identical premedication, anesthetic, and pump primes. The control patients received hypothermic nonpulsatile flow and the study patients received hypothermic pulsatile flow. Hypertension, defined as a pressure of 160/100 mm Hg or higher, was observed in 80% of the control patients and 20% of the patients receiving pulsatile flow (p less than 0.05). Serial renin measurements demonstrated maximum values in the intensive care unit and coincided with the onset of postoperative hypertension in the control patients. Those patients who had received pulsatile flow did not demonstrate notable renin stimulation. Catecholamines were markedly elevated during bypass and in the intensive care unit, but there was no significant difference between the two groups. Peripheral vascular resistance was not significantly lower with pulsatile flow, except in the first study performed in the intensive care unit. We conclude that catecholamines and the renin-angiotensin system contribute to the production of postoperative hypertension and that pulsatile flow diminishes renin stimulation. Pulsatile flow results in a decreased incidence of postoperative hypertension.

Cardiopulmonary Bypass↗
PubMed1990

The decomposition of apparent stresses in disturbed pulsatile flow in the presence of large scale organized structures.

Flow disturbance phenomena that occur in unsteady-in-the-mean flows (i.e. pulsatile or oscillating) at moderate Reynolds numbers are analyzed in both the time domain and the frequency domain. The analysis utilizes variable decomposition into a time-varying underlying waveform and flow disturbances which are composed of large scale organized structures and random fluctuations. A practical technique which incorporates time domain phase conditioning, trend removal, and frequency domain matched filtering, is presented and examined using simulated data of known statistical behavior. The applicability of the method is shown by the decomposition of the simulated data and the technique is then applied to experimental data obtained in pulsatile flow through a constricted tube by means of a laser Doppler anemometer. The cross-sectional area reduction at the constriction throat was 90%. The Womersley parameter in the experiments was 5.3 and the Reynolds number based on the average flow rate per cycle was 300 with a minimum/maximum value of 55/600 based on the instantaneous flow rate. Measurements were taken in the flow region downstream of the constriction throat which included several interesting flow disturbance phenomena. The results of the decomposed flow phenomena demonstrate the significant role of large scale organized structures in such flows. This is particularly important when analyzing blood flow in the large arteries in the presence of severe stenosis or behind prosthetic devices in an attempt to estimate the 'turbulent' stress which act on cellular elements. Estimation of the apparent stress tensor is of importance in an effort to elucidate the mechanical factors which influence the durability of red blood cells under abnormal conditions.

Biomechanical Phenomena↗
PubMed1999

Comparison of physiological and simple pulsatile flows through stenosed arteries.

Most experimental and numerical studies of pulsatile flow through stenosed arteries have been performed for a first harmonic oscillatory flow. In this paper, numerical solutions are presented for a physiological pulsatile flow as well as for an equivalent simple pulsatile flow, having the same stroke volume as the physiological flow, and the differences in their flow behavior are discussed. The analysis is restricted to laminar flow, Newtonian fluid and axisymmetric rigid stenosis. Comparison of results shows that the behaviors of the two flows are similar at some instances of time, however, important observed differences indicate that for thorough understanding of pulsatile flow behavior in stenosed arteries, the actual physiological flow should be simulated.

Algorithms↗
PubMed1997

Experimental investigation of pulsatile flows in tubes.

Based on cam-piston-valve arrangement, a mechanical pulsatile flow generator is designed to investigate sinusoidal flow and other types of pulsatile flow in straight rigid tube. Measurement reveals the relation between pressure gradient and flow rate. Numerical simulation using the k-epsilon turbulence model are carried out to compare the pulsatile flow produced by the generator with a sinusoidal flow and a physiological flow in a rigid tube. The results show that the pulsatile flow generated has similar dynamic properties to the physiological flow. Hence, the present setup can be used for in-vitro investigation of biofluid phenomena.

Aorta↗
PubMed2002

Doppler angle estimation of pulsatile flows using AR modeling.

In quantitative ultrasonic flow measurements, the beam-to-flow angle (i.e., Doppler angle) is an important parameter. An autoregressive (AR) spectral analysis technique in combination with the Doppler spectrum broadening effect was previously proposed to estimate the Doppler angle. Since only a limited number of flow samples are used, real-time two-dimensional Doppler angle estimation is possible. The method was validated for laminar flows with constant velocities. In clinical applications, the flow pulsation needs to be considered. For pulsatile flows, the flow velocity is time-varying and the accuracy of Doppler angle estimation may be affected. In this paper, the AR method using only a limited number of flow samples was applied to Doppler angle estimation of pulsatile flows. The flow samples were properly selected to derive the AR coefficients and then more samples were extrapolated based on the AR model. The proposed method was verified by both simulations and in vitro experiments. A wide range of Doppler angles (from 3o degrees to 78 degrees) and different flow rates were considered. The experimental data for the Doppler angle showed that the AR method using eight flow samples had an average estimation error of 3.50 degrees compared to an average error of 7.08 degrees for the Fast Fourier Transform (FFT) method using 64 flow samples. Results indicated that the AR method not only provided accurate Doppler angle estimates, but also outperformed the conventional FFT method in pulsatile flows. This is because the short data acquisition time is less affected by the temporal velocity changes. It is concluded that real-time two-dimensional estimation of the Doppler angle is possible using the AR method in the presence of pulsatile flows. In addition, Doppler angle estimation with turbulent flows is also discussed. Results show that both the AR and FFT methods are not adequate due to the spectral broadening effects from the turbulence.

Blood Flow Velocity↗
PubMed1993

Hemodialysis: evidence of enhanced molecular clearance and ultrafiltration volume by using pulsatile flow.

We describe several in vitro experiments showing evidence that pulsatile flow hemodialysis enhances ultrafiltration volume and molecular clearance as compared with steady flow hemodialysis. A new pulsatile pump and a conventional roller pump were compared using different hollow fiber dialyzers and a simulated blood solution containing urea, aspartame and vitamin B-12 at different flow rates and configurations. Ultrafiltration volume and concentration of urea, aspartame and B-12 were measured and molecular clearance (K) calculated. Ultrafiltration volume markedly increased with pulsatile flow. After 10 min K for urea with pulsatile flow was higher in all experiments even when ultrafiltration was prevented. Clearance of aspartame and B-12 also increased with pulsatile flow. We propose three mechanisms by which pulsatile flow is more efficient than steady flow hemodialysis: greater fluid energy, avoidance of molecular channeling and avoidance of membrane layering. We hypothesize that using pulsatile flow in hemodialysis can significantly shorten the duration of dialysis sessions for most of the patients, and consequently reduce the duration of the procedure and its cost.

Aspartame↗
PubMed2001

Doppler power variation from porcine blood under steady and pulsatile flow.

Although a number of recent studies have demonstrated that the echogenicity of blood varies as a function of time under pulsatile flow, the fundamental mechanisms responsible for it are still uncertain. To better understand this phenomenon, the Doppler power from porcine blood and polystyrene microsphere suspensions was measured at the center of the tube as functions of two crucial parameters, flow velocity and stroke rate (for pulsatile flow), under steady and pulsatile flow in a mock flow loop. In the present study, the experimental results were obtained with a 10-MHz pulsed Doppler system with a frequency response estimated more accurately by electronic injection, and validated by comparing to the radiofrequency (RF) signal acquired from the same Doppler instrument. The results show that the Doppler power from microspheres and porcine red blood cell (RBC) suspensions did not vary appreciably (< 2 dB), with either the speed or stroke rate (for pulsatile flow only) under steady and pulsatile flow. It was found that the Doppler power from porcine whole blood under steady flow decreased with the speed by approximately 13 dB from 3 to 33 cm/s and was only 3 dB higher than that from RBC suspension at 33 cm/s, suggesting minimal RBC aggregation in whole blood at this speed. The apparent cyclic variation from whole blood was observed at 20 and 40 beats/min (BPM). The cyclic variation became more obvious as the speed and stroke rate decreased. The mean Doppler power over a cycle increased as the peak speed decreased. The Doppler power reached a maximum near peak systole and a minimum at late diastole at the center of the tube. This pattern cannot be explained by RBC aggregation due to the shear rate alone, and may be attributed to acceleration and deceleration along with aggregation. The cyclic variation was not observed at 60 BPM, probably because of a lack of time for aggregation to occur.

Activity Cycles↗
PubMed1983

Adrenocortical hormone levels during cardiopulmonary bypass with and without pulsatile flow.

To determine the effect of hypothermic pulsatile and nonpulsatile cardiopulmonary bypass (CPB) with hemodilution on adrenocortical function we measured plasma levels of adrenocorticotropic hormone (ACTH), cortisol, aldosterone, and renin in two groups of patients. Group I, comprising 11 patients had routine CPB (nonpulsatile), and Group II, comprising 12 patients, had pulsatile flow during CPB (pulsatile). Both groups demonstrated comparable increases in cortisol, ACTH, and aldosterone with operation. Levels for all three hormones appeared to decline during CPB and then rose again in the post-CPB period. There were no significant differences between groups. Plasma renin activity gradually declined in a comparable manner in both groups. In the post-CPB period, renin activity was slightly higher in the nonpulsatile group (1.7 +/- 0.5 versus 0.8 +/- 0.2 ng/ml/hr, p less than 0.05). Correction for the effect of hemodilution demonstrated no decrease in cortisol and a slight increase in ACTH in both groups during CPB. Significant increases occurred in both groups during CPB in urinary Na+ excretion rate and urinary Na+/K+ ratio, more so for the nonpulsatile group. There was no correlation between urinary Na+/K+ ratios and either plasma cortisol or aldosterone levels. Thus routine CPB demonstrates no evidence of adrenocortical hypofunction and the addition of pulsatile flow produces little improvement.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Instantaneous cross-sectional flow velocity profiles: a comparative study of two ultrasound Doppler methods applied to an in vitro pulsatile flow model.

Two methods based on different techniques for construction of cross-sectional flow velocity profiles from Doppler ultrasound signals were compared: an intraluminal method using pulsed-wave Doppler echocardiography and an extraluminal method using two-dimensional (color) Doppler ultrasound. The methods were applied to an in vitro pulsatile flow model. With the intraluminal method, pulsed Doppler recordings obtained throughout several flow pulses at different positions across a tube were digitized, and cross-sectional flow velocity profiles were obtained by matching the onset of flow velocity at the various positions. With the extraluminal method, cross-sectional flow velocity profiles were obtained by time interpolation between the digital flow velocity data obtained from several flow velocity maps. The first flow velocity map was recorded at onset of flow and the following maps were incrementally delayed with 20 msec from one flow pulse to the next. The time lag caused by the time needed to update each of the flow velocity maps was compensated for by time interpolation between the sequentially recorded flow velocity maps. The cross-sectional flow velocity profiles obtained with the two methods were compared at identical positions within the tube model at equal flow settings and throughout the pulsatile flow periods. At three different flow settings with peak flow velocity of 0.3, 0.5, and 0.7 m/sec, the difference (mean +/- SD) between the obtained velocities were 0.01 +/- 0.04, -0.01 +/- 0.05, and -0.03 +/- 0.07 m/sec, respectively. The findings suggest that cross-sectional flow velocity profiles from pulsatile flow velocity recordings can be obtained equally well with both methods.

Blood Flow Velocity↗
PubMed1992

[Clinical and experimental study of the production of renal hemodynamic effects of IABP-assisted pulsatile flow extracorporeal circulation].

Renal hemodynamics during IABP-assisted pulsatile flow extracorporeal circulation was assessed in terms of measurement values for intraoperative renal blood flow obtained by the local thermodilution method in human clinical patients. In addition, the effect of IABP on renal hemodynamics was investigated in an animal model of renal denervation in a study undertaken to elucidate the action mechanism of IABP. Eighteen patients with acquired heart disease were involved in the study and measured for the renal blood flow (RBF), cardiac output (CO), renal-systemic partition coefficient for blood flow (RBF/CO), renal vascular resistance (RVR) and perfusion pressure. In the pulsatile flow group, the RBF/CO increased as the number of pump runs increased, whole the RVR was conversely reduced with increasing pump runs. The experimental study without extracorporeal circulation was conducted on 19 mongrel dogs. During IABP runs RBF/CO increased, while the RVR decreased. After renal denervation, no noticeable influence of IABP upon renal hemodynamics was observed. Following a loading dose of noradrenaline (Norad), the RVR increased in a Norad concentration-dependent fashion, independently of IABP and renal denervation. These results indicate that IABP reduces the RVR and thereby exerts a favorable action on renal hemodynamics during pump times. The study thus warrants us to surmise that a mechanism involving the renal sympathetic nerves might play an important role in the production of favorable renal hemodynamic effects of IABP-assisted pulsatile flow extracorporeal circulation.

Animals↗
PubMed1979

Plasma vasopressin levels and urinary flow during cardiopulmonary bypass in patients with valvular heart disease: effect of pulsatile flow.

The effect of pulsatile flow on plasma vasopressin levels during cardiopulmonary bypass (CPB) was studied in 20 patients undergoing open valve replacement. Routine bypass was used in 10 patients and the AVCO pulsatile bypass pump was utilized in the other 10. In Group I (nonpulsatile) during CPB, the vasopressin level was markedly elevated (3.1 +/- 2 to 80 +/- 22 pg/ml) as was urine flow (0.6 +/- 0.2 to 5.9 +/- 2 ml/min) and urine Na+ concentration (69 +/- 19 to 116 +/- 7 mEq/L). In Group II (pulsatile) during CPB, the vasopressin level (3.8 +/- 3 to 54 +/- 14 pg/ml), urine flow (0.6 +/- 0.1 to 16.2 +/- 4.8 ml/min), and urine Na+ concentrations (61 +/- 13 to 97 +/- 10 mEq/L) were also elevated. The rise in vasopressin and urine Na+ was less in the pulsatile group (p less than 0.05) whereas the urine flow was higher (p less than 0.05). To maintain comparable blood pressure, the pulsatile flow group required significantly higher flows (4.5 +/- 0.2 compared to 3.8 +/- 0.2; p less than 0.05). These data suggest that CPB produces a marked vasopressin stress response which is beyond the physiological range for an antidiuretic effect on the kidney. At these levels vasopressin can exert a vasopressor effect to maintain resistance and affect renal blood flow, as well as producing an Na+ diuresis. The addition of pulsatile flow creates a more physiological situation attenuating the vasopressin response and producing a decrease in systemic resistance and a less pronounced Na+ diuresis.

Arginine Vasopressin↗
PubMed1995

Magnetic resonance imaging kappa-space segmentation using phase-encoding groups the accuracy of quantitative measurements of pulsatile flow.

The use of phase-encode grouping (PEG) allows acquisition of a complete cardiac cine in a single breath hold, eliminating respiratory artifacts and improving edge definition. One approach to quantitative magnetic resonance (MR) flow measurements in pulmonary, coronary, and renal arteries uses phase velocity mapping with a PEG, single breath-hold, cine technique. Phantom studies were designed to evaluate the accuracy of MR phase velocity mapping (MRV) with PEG in continuous and pulsatile flow measurements in small vessels. Experiments were performed on a 1.5-T MRI system and results were compared with those obtained by timed volume measurements and a transit-time ultrasound flowmeter. Flow velocity, pulsatile flow wave form, pulsing rate, and PEG size were varied. For continuous flow, MRV measured velocities correlated well with those calculated from timed volume measurements (r > 0.998) under mean spatial velocities ranging from 20-100 cm s-1. The temporal mean velocity difference between MRV and ultrasound flowmeter measurements was less than +/- 2.9 cms-1 under pulsatile flow conditions with PEG sizes of 5 or less, however, the mean velocity difference was > 7 cm s-1 for PEG sizes of 8 or more. Accurate MR velocity measurement with PEG in small vessels under conditions of pulsatile flow is possible if an appropriate PEG size is selected.

Artifacts↗
PubMed2003

Regurgitant flow field characteristics of the St. Jude bileaflet mechanical heart valve under physiologic pulsatile flow using particle image velocimetry.

The regurgitant flow fields of clinically used mechanical heart valves have been traditionally studied in vitro using flow visualization, ultrasound techniques, and laser Doppler velocimetry under steady and pulsatile flow. Detailed investigation of the forward and regurgitant flow fields of these valves can elucidate a valve's propensity for blood element damage, thrombus formation, or cavitation. Advances in particle image velocimetry (PIV) have allowed its use in the study of the flow fields of prosthetic valves. Unlike other flow field diagnostic systems, recent work using PIV has been able to relate particular regurgitant flow field characteristics of the Bjork-Shiley Monostrut valve to a propensity for cavitation. In this study, the regurgitant flow field of the St. Jude Medical bileaflet mechanical heart valve was assessed using PIV under physiologic pulsatile flow conditions. Data collected at selected time points prior to and after valve closure demonstrated the typical regurgitant jet flow patterns associated with the St. Jude valve, and indicated the formation of a strong regurgitant jet, in the B-datum plane, along with twin vortices near the leaflets. Estimated ensemble-average viscous shear rates suggested little potential for hemolysis when the hinge jets collided. However, the vortex motion near the occluder tips potentially provides a low-pressure environment for cavitation.

Blood Flow Velocity↗
PubMed1992

Factors determining aortic and umbilical blood flow pulsatility in fetal sheep.

The link between the flow pulsatility index (P.I.) and vascular resistance was examined by infusing vasoactive agents or by progressive embolization of the peripheral vascular bed. Experiments were performed on fetal sheep near term, 3 days after implantation of a flow probe, catheter-tip pressure transducers, and fluid-filled catheters to monitor hemodynamics in the umbilical artery and the descending thoracic aorta. Increasing placental and hind limb resistance by embolization with microspheres caused a progressive increase in flow P.I. whereas altering resistance with vasoactive agents had variable results. Results showed that flow P.I. was sensitive to impedance to pulsatile flow and pressure pulsatility in addition to vascular resistance. We conclude it is hazardous to use the flow P.I. to detect changes in vascular resistance particularly when these changes are induced by physiological adjustments or vasoactive agents.

Animals↗