Peripheral Intravenous Catheter (PIVC) is generally used for medical treatments of infusing fluids, drug and transfusions in hospitals. In many cases of the treatments for patients, thrombus sometimes occurs near the catheter during the infusion. Especially in case of infants (until 2 years old), the possibility of thrombus formation is more frequent than that in case of adults. The reasons have not been elucidated yet, but they are considered to be shear rate near the catheter, catheter motion and infants’ crying. In case of adults, recent CFD work pointed out the importance of high wall shear stress (WSS) by impinging jet flow of catheter for the thrombus generation. But the parameter such as flow rate of infusion in this CFD is extremely high comparing with clinical flow rate of infusion even though the vein diameter is large. In addition to this, the ratio between the vein diameter and the catheter diameter in case of infants is apparently larger than that in case of adults. Then it is necessary to elucidate the mechanism of thrombus formation near the catheter tip in the infant’s vein.In this stufy, effects of the catheter position, venous flow and infusion flow on the thrombus formation are examined by the CFD model composed of the catheter and the infant’s vein, and the evaluation methods are proposed. As for the crying effects, the slight pulsatile pressure was added to the vein steady flow for simulating it. &nbsp;In methodology, there are two models composed of the catheter and vein. One is a model before reaching the catheter to the wall of vein (Incomplete Insertion), the other is a model after fixing the catheter on the wall (Complete Insertion). As for the infusion flow rate in the catheter, it changes from 0[ml/h] to 15[ml/h]. When the flow rate is 0[ml/h], it is called “OFF mode”. And it is “ON mode” for other flow rates. In this investigation, the shear rate and the residence time are used for evaluation of thrombus formation. Especially the probability of thrombus formation is evaluated as the product of strain rate and residence time near the wall.As for the result of the prediction of residence time, it is found that there is a high residence region between the catheter and the vein wall. From the calculation of evaluation, it is also found that the highest risk of thrombus formation will be occur in case of Complete Insertion and OFF mode. From these results, it is necessary for clinicians or nurses to start injecting as soon as possible after the catheter’s penetrating the vein wall. It was concluded that there is high probability area of thrombus formation between the catheter and the vein wall in case of infants. [1]R. Piper et.al., Scientific Reports, 8:3441, 2018, (DOI: 10.1038/s41598-018-21617-1)

Prediction of Thrombus Formation Around a Peripheral Intravenous Catheter for Infants

Paper Proceedings: https://asmedigitalcollection.asme.org/IMECE/IMECE2021/volume/85543

ASME 2021 International Mechanical Engineering Congress and Exposition (IMECE2021)

Supporting the need among researchers worldwide for additional online and multimedia content, ASME now offers the ASME Conference Video Collection. This platform will collect and provide long-term access to conference presentation videos, encompassing all technology areas within ASME's technical conference and events program. About 30,000-40,000 engineers across all mechanical engineering and related disciplines participate in ASME conferences each year. This includes authors of approximately 6,000 to 8,000 technical papers published by ASME, the majority of whom also submit video presentations for our virtual conferences. The video collection will be available as an add-on to existing product packages or as a separate subscription.