Characterizing and Optimizing Hematologic Complications in ECMO Therapy

Abstract

Extracorporeal membrane oxygenation (ECMO) is a life support technology used in severe cardiac and pulmonary failure. However, it is frequently associated with thrombotic and bleeding complications caused by abnormal shear stress and blood–device interactions. This thesis investigates how hollow fiber alignment in oxygenators influences shear stress distribution and hematologic responses to improve hemocompatibility for ECMO therapy. Computational fluid dynamics simulations compare a conventional aligned fiber arrangement with a staggered configuration. The staggered design reduced peak wall shear stress by about 30 percent and lowered pressure drop, indicating more uniform flow. Experimental validation using 3D-printed microfluidic devices and whole-blood perfusion showed a reduction in von Willebrand factor deposition and platelet accumulation by approximately 30 percent in the staggered design. These results demonstrate that fiber geometry strongly influences thrombogenic potential. Structural optimization offers an effective strategy to reduce blood damage and improve ECMO performance without changes to materials or anticoagulation.