Modeling Anisotropic Electrical Conductivity of Blood: Translating Microscale Effects of Red Blood Cell Motion into a Macroscale Property of Blood.

Cardiovascular diseases are a leading global cause of mortality. The current standard diagnostic methods, such as imaging and invasive procedures, are relatively expensive and partly connected with risks to the patient. Bioimpedance measurements hold the promise to offer rapid, safe, and low-cost alternative diagnostic methods. In the realm of cardiovascular diseases, bioimpedance methods rely on the changing electrical conductivity of blood, which depends on the local hemodynamics. However, the exact dependence of blood conductivity on the hemodynamic parameters is not yet fully understood, and the existing models for this dependence are limited to rather academic flow fields in straight pipes or channels. In this work, we suggest two closely connected anisotropic electrical conductivity models for blood in general three-dimensional flows, which consider the orientation and alignment of red blood cells (RBCs) in shear flows. In shear flows, RBCs adopt preferred orientations through a rotation of their membrane known as tank-treading motion. The two models are built on two different assumptions as to which hemodynamic characteristic determines the preferred orientation. The models are evaluated in two example simulations of blood flow. In a straight rigid vessel, the models coincide and are in accordance with experimental observations. In a simplified aorta geometry, the models yield different results. These differences are analyzed quantitatively, but a validation of the models with experiments is yet outstanding.

Morphological parameters affecting false lumen thrombosis following type B aortic dissection: a systematic study based on simulations of idealized models.

Type B aortic dissection (TBAD) carries a high risk of complications, particularly with a partially thrombosed or patent false lumen (FL). Therefore, uncovering the risk factors leading to FL thrombosis is crucial to identify high-risk patients. Although studies have shown that morphological parameters of the dissected aorta are related to FL thrombosis, often conflicting results have been reported. We show that recent models of thrombus evolution in combination with sensitivity analysis methods can provide valuable insights into how combinations of morphological parameters affect the prospect of FL thrombosis. Based on clinical data, an idealized geometry of a TBAD is generated and parameterized. After implementing the thrombus model in computational fluid dynamics simulations, a global sensitivity analysis for selected morphological parameters is performed. We then introduce dimensionless morphological parameters to scale the results to individual patients. The sensitivity analysis demonstrates that the most sensitive parameters influencing FL thrombosis are the FL diameter and the size and location of intimal tears. A higher risk of partial thrombosis is observed when the FL diameter is larger than the true lumen diameter. Reducing the ratio of the distal to proximal tear size increases the risk of FL patency. In summary, these parameters play a dominant role in classifying morphologies into patent, partially thrombosed, and fully thrombosed FL. In this study, we point out the predictive role of morphological parameters for FL thrombosis in TBAD and show that the results are in good agreement with available clinical studies.

A Bayesian approach to blood rheological uncertainties in aortic hemodynamics.

Computational hemodynamics has received increasing attention recently. Patient-specific simulations require questionable model assumptions, for example, for geometry, boundary conditions, and material parameters. Consequently, the credibility of these simulations is much doubted, and rightly so. Yet, the matter may be addressed by a rigorous uncertainty quantification. In this contribution, we investigated the impact of blood rheological models on wall shear stress uncertainties in aortic hemodynamics obtained in numerical simulations. Based on shear-rheometric experiments, we compare the non-Newtonian Carreau model to a simple Newtonian model and a Reynolds number-equivalent Newtonian model. Bayesian Probability Theory treats uncertainties consistently and allows to include elusive assumptions such as the comparability of flow regimes. We overcome the prohibitively high computational cost for the simulation with a surrogate model, and account for the uncertainties of the surrogate model itself, too. We have two main findings: (1) The Newtonian models mostly underestimate the uncertainties as compared to the non-Newtonian model. (2) The wall shear stresses of specific persons cannot be distinguished due to largely overlapping uncertainty bands, implying that a more precise determination of person-specific blood rheological properties is necessary for person-specific simulations. While we refrain from a general recommendation for one rheological model, we have quantified the error of the uncertainty quantification associated with these modeling choices.

Monitoring of false lumen thrombosis in type B aortic dissection by impedance cardiography - A multiphysics simulation study.

Aortic dissection is caused by a tear on the aortic wall that allows blood to flow through the wall layers. Usually, this tear involves the intimal and partly the medial layer of the aortic wall. As a result, a new false lumen develops besides the original aorta, denoted then as the true lumen. The local hemodynamic conditions such as flow disturbances, recirculations and low wall shear stress may cause thrombus formation and growth in the false lumen. Since the false lumen status is a significant predictor for late-dissection-related deaths, it is of great importance in the medical management of patients with aortic dissection. The hemodynamic changes in the aorta also alter the electrical conductivity of blood. Since the blood is much more conductive than other tissues in the body, such changes can be identified with non-invasive methods such as impedance cardiography. Therefore, in this study, the capability of impedance cardiography in monitoring thrombosis in the false lumen is studied by multiphysics simulations to assist clinicians in the medical management of patients under treatment. To tackle this problem, a 3D computational fluid dynamics simulation has been set up to model thrombosis in the false lumen and its impact on the blood flow-induced conductivity changes. The electrical conductivity changes of blood have been assigned as material properties of the blood-filled aorta in a 3D finite element electric simulation model to investigate the impact of conductivity changes on the measured impedance from the body's surface. The results show remarkable changes in the electrical conductivity distribution in the measurement region due to thrombosis in the false lumen, which significantly impacts the morphology of the impedance cardiogram. Thus, frequent monitoring of impedance cardiography signals may allow tracking the thrombus formation and growth in the false lumen.

Universality of stretching separation.

We develop a model to predict the fragmentation limit of drops colliding off-centre. The prediction is excellent over a wide range of liquid properties and it can be used without adjusting any parameter. The so-called stretching separation is attributed to the extension of the merged drop above a critical aspect ratio of 3.25. The evolution of this aspect ratio is influenced by the liquid viscosity and can be interpreted via an energy balance. This approach is then adapted to drop-jet collisions, which we model as consecutive drop-drop collisions. The fragmentation criterion is similar to the one observed for drop-drop collisions, while the evolution of the stretched jet aspect ratio is modified to account for the different flow fields and geometry.

Interactions between particles with an undulated contact line at a fluid interface: capillary multipoles of arbitrary order.

A colloidal particle adsorbed at a fluid interface could have an undulated, or irregular contact line in the presence of surface roughness and/or chemical inhomogeneity. The contact-line undulations produce distortions in the surrounding liquid interface, whose overlap engenders capillary interaction between the particles. The convex and concave local deviations of the meniscus shape from planarity can be formally treated as positive and negative "capillary charges," which form "capillary multipoles." Here, we derive theoretical expressions for the interaction between two capillary multipoles of arbitrary order. Depending on the angle of mutual orientation, the interaction energy could exhibit a minimum, or it could represent a monotonic attraction. For undulation amplitudes larger than 5 nm, the interaction energy is typically much greater than the thermal energy kT. As a consequence, a monolayer from capillary multipoles exhibits considerable shear elasticity, and such monolayer is expected to behave as a two-dimensional elastic solid. These theoretical results could be helpful for the understanding of phenomena related to aggregation and ordering of particles adsorbed at a fluid interface, and for the interpretation of rheological properties of particulate monolayers. Related research fields are the particle-stabilized (Pickering) emulsions and the two-dimensional self-assembly of microscopic particles.

Comparison of aerosol therapy with different perfluorocarbons in surfactant-depleted animals.

OBJECTIVE: The study investigates the effectiveness of aerosol treatment on gas exchange and pulmonary inflammatory reaction using perfluorocarbons with different molecular structure and vapor pressure. DESIGN: Experimental, prospective, randomized, controlled study. SETTING: Experimental laboratory at a university hospital. SUBJECTS: Twenty anesthetized neonatal piglets assigned to four groups. INTERVENTIONS: After establishment of lung injury by bronchoalveolar lavage, piglets either received aerosolized FC77 (n = 5), perfluorooctylbromide (n = 5), or FC43 (n = 5, 10 mL x kg(-1) x hr(-1) for 2 hrs) or intermittent mandatory ventilation (control, n = 5). Thereafter, animals were supported for another 6 hrs. MEASUREMENTS AND MAIN RESULTS: Pao2 significantly improved in the perfluorocarbon groups compared with control (p < .01). Final Pao2 (mean +/- SEM) was FC77, 406 +/- 27 mm Hg; perfluorooctylbromide, 332 +/- 32 mm Hg; FC43, 406 +/- 19 mm Hg; control, 68 +/- 8 mm Hg. Paco2 and mean pulmonary arterial pressure were lower in all perfluorocarbon groups compared with control. The ratio of terminal dynamic compliance to total compliance was significantly higher in the FC77 than in the FC43, perfluorooctylbromide, and control groups. Relative gene expression of interleukin-1beta, interleukin-8, P-selectin, E-selectin, and intercellular adhesion molecule-1 in lung tissue was determined by TaqMan real time polymerase chain reaction normalized to hypoxanthineguanine-phosphoribosyl-transferase and was shown to be reduced by all perfluorocarbons. CONCLUSIONS: Aerosol treatment with all the perfluorocarbons investigated improved gas exchange and reduced pulmonary inflammatory reaction independently from molecular structure and vapor pressure of the perfluorocarbons. Although differences in vapor pressure and molecular structure may account for varying optimal dosing strategies, several different perfluorocarbons were shown to be principally suitable for aerosol treatment.