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Introduction: In peripheral percutaneous (VA) extracorporeal membrane oxygenation (ECMO) procedures the femoral arteries perfusion route has inherent disadvantages regarding poor upper body perfusion due to watershed. With the advent of new long flexible cannulas an advancement of the tip up to the ascending aorta has become feasible. To investigate the impact of such long endoluminal cannulas on upper body perfusion, a Computational Fluid Dynamics (CFD) study was performed considering different support levels and three cannula positions.
Methods: An idealized literature-based- and a real patient proximal aortic geometry including an endoluminal cannula were constructed. The blood flow was considered continuous. Oxygen saturation was set to 80% for the blood coming from the heart and to 100% for the blood leaving the cannula. 50% and 90% venoarterial support levels from the total blood flow rate of 6 l/min were investigated for three different positions of the cannula in the aortic arch.
Results: For both geometries, the placement of the cannula in the ascending aorta led to a superior oxygenation of all aortic blood vessels except for the left coronary artery. Cannula placements at the aortic arch and descending aorta could support supra-aortic arteries, but not the coronary arteries. All positions were able to support all branches with saturated blood at 90% flow volume.
Conclusions: In accordance with clinical observations CFD analysis reveals, that retrograde advancement of a long endoluminal cannula can considerably improve the oxygenation of the upper body and lead to oxygen saturation distributions similar to those of a central cannulation.
It is well known that the already large dielectric constants of some electrolytes like BaTiO₃ can be enhanced further by adding metallic (e.g. Ni, Cu or Ag) nanoparticles. The enhancement can be quite large, a factor of more than 1000 is possible. The consequences for the properties will be discussed in the present paper applying a brick-layer model (BLM) for calculating dc-resistivities of thin layers and a modified one (PBLM) that includes percolation for calculating dielectric properties of these materials. The PBLM results in an at least qualitative description and understanding of the physical phenomena: This model gives an explanation for the steep increase of the dielectric constant below the percolation threshold and why this increase is connected to a dramatic decrease of the breakdown voltage as well as the ability of storing electrical energy. We conclude that metallic electrolyte composites like BaTiO₃ are not appropriate for energy storage.