Mechanized lymphatic drainage in acute decompensated heart failure. A study on a hydrodynamic test bench

Abstract

Objective: to investigate the effectiveness of a new mechanized lymphatic drainage method in acute decompensated heart failure (ADHF) modeling through local reduction in venous pressure in the site of lymphatic drainage from the thoracic duct.Materials and methods. Main components of the device are a catheter with built-in inlet and outlet mechanical valves designed for insertion into the left brachiocephalic vein through the left internal jugular vein. It comes with an extracorporeal drive system made as a valveless pulsator pump with a 10 ml shock discharge and a controller ensuring preset frequency and pressure/rarefaction duty cycle. The operating principle of the device is based on local reduction of venous pressure in the site of lymphatic drainage from the thoracic duct (in the junction of the left internal jugular and subclavian veins).Results. When modeling hydrodynamics under ADHF conditions on a hydrodynamic test bench, the upper venous flow through the left brachiocephalic vein was 0.4 l/min, the pressure in the site of lymphatic drainage from the thoracic duct, was decreased from 20–25 mmHg to 0–5 mmHg due to operation of the mechanized drainage device with suction/injection phase duration ratio 0.2/0.8 and pulsator pump operating frequency from 30 to 60 beats/min.

Keywords

• lymphatic system
• thoracic duct
• heart failure
• local decrease in venous pressure
• catheter
• pulsator pump