A Novel Injection System for Hypovolemic Patients

The aim of this paper is to test a new infusion system prototype which is intended to recover the normal venous return and lost blood quantity in hypovolemic patients. For this purpose a bolus of fluid is injected at a high speed in the vena cava, accelerating and dragging the stagnating flow upstream the catheter. In order to improve the effects of the injection and to avoid damage to heart valves, the injection is synchronized with the heart cycle and should be controlled by the electrocardiogram track of the patient in such a way that the maximum flow rate injected occurs when the tricuspid valve is open. An in-vitro experimental apparatus — simulating the vena cava and its environment — has been built and used to measure velocity and pressure fields in the vena cava during the high velocity injection. In a first embodiment, the experimental apparatus consists of two reservoirs arranged, respectively, upstream and downstream a Starling Resistor, but at different heights. A constant flow rate inside the vena cava is maintained, thus simulating the diastolic phase of the heart. In a second embodiment of the experimental apparatus, two electrical valves, arranged downstream the Starling Resistor, generate an oscillating pressure wave along the vena cava, thus simulating the human central venous pressure. By varying the flow rate inside the vena cava and the opening rate of the valves, it has been possible to evaluate the dragging effect of the new injection system and the mechanical behavior of the vena cava during both continuous and pulsating infusion.