PEER REVIEW PAPER

Performance Characteristic Determination of

A Roller Pump for Extracorporeal Circulation
For Different Working Conditions
P. Cappa, F. Marinozzi, and S.A. Sciuto
P. Cappa an d F. Marinozzi are with the Department ofMechanics an d Aeronautics, University ofRome "La
Sapienza," via Eudossiana 18-00184 in Rome, Italy. P. Cappa is also with the Clinica{ Engineering Service, Children's
llospital "Bambino Ges" ofRome, piazza S. Onofrio 4-00165 in Rome, Italy, as is S.A. Sciuto. Sciuto is also with the
Department ofMechanical ami Industriai Engineering, ffi University ofRome, via della Vasca Navale 79- 00146 in
Rome, Italy.
Abstract
The pertrmance of a Verticlude roller pump is experimentally evaluated far different working
conditions. The resulting tlow-pressure curves are reported far different: (a) evolving fluids; (b) fluid tempera-
tures; and (c) pump settings. These settings include rotation speed and occlusion leve/, currently used in the
heart-surgery practice at the Heart-Surgery Oepartment of the Chi/dren's Hospita/ "Bambino CesL" of Rome
{/ta/y). The experimental test resu/ts illustrate (a) the relevant sensitivity of the pump perrrmance to sma/1
working condition variations and (b) the consequent indetermination in patient perfusion fluid-dynamics.
This has caused perfusionists to focus greater attention on occlusion leve! during pump setting.
Extracorporeal circulation (ECC), as is well known, is a
widdy used technique allowing for temporary cardiac arrest
during heart-surgery operations [ 1]. In ECC circuir the only
active elcment is the pump ofwhich there are two common
types: (a) peristaltic, which produces pulsati le fio w [2-8] ami
(b) centrifugai, which produces continuous fio w [9 an d I 0].
The mai n differences between the two types of flow are in
blood damage leve! an patient perfusion inuce effects. Re-
cent studies for the experimental evaluation of hemolysis leve!
ami platelet damage inuce by ECC pumps, contm1 that peri-
stai tic pumping performed by roller pumps causes greater
hloOl trauma, which leas to both hemolysis and thrombus
formations.This is thought to be due to red cells squashing
hetween pipe walls [ 11-20].However, roller pumps are gener-
ally prefciTe over the continuous pumps for enhance patient
pert'usion [21-23].
The a reduce hemolysis leve! ami a bet-
ter perfusion achieved by means of a pulsati le flow was the
m:tin reason for leading studies into the modif;cation of cen-
trifug:il pumps. In fact, streamlined impeller [ 2-i an d 25] or
nlveless centrifugai pumps were esigned to produce physi-
ological pressure ami flow similar to those produce by other
pulsatile pumps [l O]. In either case, development an d use oftlle
ahove mentioned centrifugai pumps is very complex in actual
pr:tctice.Therefore, working conditions are generally not yet
suit:tble in common open-heart surgery. O n the orher han, the
elevate reliability, e a se of use an d conrrol of roller pumps are
t h e mai n reasons for their w i de use in open-heart surgery. Fur-
thermore, in a recent paper [26], the rates ofhemolysis were
compared in vitro for t h e two pump types operating in neo-
nata! ECC conditions. In this particular case, the reported results
do not confirm the previous indicated statements on higher
bloo amages induce by roller pump compared to rhe cen-
trifugai pump when they are use for aclult patients. In fact,
there was no significant differences in hemolysis rate, blood
trauma cause by these pump rypes at low flow ami high pres-
sure conitions typical for neonata! patients.l11ese results con-
trm the reason for choosing roller pumps in the Heart-Surgery
Department of the Children Hospital "Bambino Ges" of Rome.
The Clinica! Engineering Service (CES), .. in conjunction
with the Heart Surgery Department, decided to study the per-
formance of ECC circuits in orer to etermine the opti mal
"\Vorking conition for safe ami effective use in t h e operating
theater. In a previous phase of the research project, a new an d
simple methoology for non-invasiYe monitoring ofthe deliv-
*The Children's Hospical .. Bambino .. {about 800 bed medicai
t:Jcility), which is a ;llld non-prott-making hospilill located in
Vatican Cily, i. e., Papa/ state: within the city or Rome
(ltaly). and is otcially by the lwlian Gotemment as a
.. Rescarch and Care lnstitute o{ ;J Sciemitc Nature.
**The Clinica/ Engineering Serticc:. in 1980 al)(/ operative
since /98/, managcs about 5.00 detices (about $-J2
million US va/ue).
362 )ournal of Clinica! Engineering November/December 1999
ered fluiti pressure was pro-
posed an d experimemally ex-
amined [27]. In this method,
measurements were taken im-
meiately before the patient
began working condition, as an
alarm for suden pressure in-
crease an fluid-ynamic con-
dition cllange. This method,
hased o n t Ile detection of de-
livery tube radiai displacement
as a function of the internai
pressure variation, showed
some limitations mainly due to
unsatisfactory performance of
the adopted tube blocking sys-
tem in proximity of the mea-
suring section. The effect in-
duced by a membrane oxygen-
ator o n t Ile pressure waveform
propagating downstream of
tlle device was investigated.
Verticlude pump

I
I IO cm
Measuring section
lksults show that the achiev-
ing of peristaltic flow at pa-
tient levd is qui te diftcult due
to the signitcant reduction of
the pulsatile components of
the pressure signa! imposed by
Figure I: Schemc of the simulatcd extracorporea/ circu/ation circuit: A, Vertic/ude
pump; B, pump delivery; C, transducer support; D, flow transducer; E, pressure
transducer; F, heat exchanger; G, oxygenator; H, valve; I, delivery reservoir; L,
suction reservoir; M, pump suction.
the pum p [ 28] .Thus, the limitation of the effectiveness of the
t:fforts in pump design for the reproduction of physiological
waveform emerged.
In the present phase of the research, the determination of
the mechanical performances of the six in eh roller pump used
a t our Heart-Surgery Department seemed of interest in order
t o estimate the actual characteristic ofthe flow delivered to the
patient, which the perfused oxygen leve! depends upon. For
this reason,it is relevant to know the relationship between flow
ami pressure imposed by the roller pump as a function of
different pump settings, i. e. the rotation speed and the clear-
ance between housing and rolls. In fact, t h e indicated clearance
is always prese n t so as no t to completely occlude t h e pipe an d,
consequently, t o reduce hemolysis. Related to this issue, the oc-
clusi nn calibration process suggested in [29], i. e. to ha ve a wa-
ter back-flow a t a speed of about 3 cm/mi n w ben the pressure
head is 30 cm H
2
0 and the pipe is positioned vertically, is no t
easy to achieve in usual practice.Therefore,our Heart-Surgery
Department has adopted the practice oftotally occluding the
pipe, and then, unscrewing the regulating knob a halfmm from
t h a t position.'I11erefore, for these ami other different geometrie
reasons, roller pumps do not behave as volumetlic ones, i.e.
with a vertical"flow-head" curve and a direct proportionality
between flow an d rpm [29 an d 30].
In consideration ofthe above cited statements, we invesri-
gated the effects on pump behavior caused by different: (a)
evolving fluids; (b) flui d temperatures; an d (c) pump settings,
sue h as rotation speed and occlusion leve!, according to the
actual heart-surgery pracrice. I t is also relevant to underline
that pump manufacturers do nor generally provide informa-
tion o n the t h ree previously indicated effects, despite their rel-
evance for correct ECC design.
Experimental Procedures
TI1e ECC hydraulic circuir is made up of: (a) a pump, (b) an
oxygenaror, (c) a beat exchanger, (d) a reservoir an d (e) the
polyvinyl-chloride (PVC) tubing circuir.
In order t o identify the mechanical perfom1ances of roller
pumps used in our Heart-Surgery Department, a specific ex-
pelimental set-up was developecl (Fig.l ).A simplified ECC cir-
cuir was developed using: (a) a heart-lung machine with the
pump connected t o (b) a beat exchanger connected t o a ther-
moregulated flui d hearer for remperJture contro l, (c) an oxy-
genator, (d) a delivery reservoir elevated to Il O cm height over
pump suction leve! in order t o simulate, as suggested by heart
surgeons, a steady-state condition of the mean pressure (about
SO m m Hg) t ha t rh e biomi has t o overcome a t the cardiopathic's
aortic cannula entrance an d, finally, (e) an open recipient,as a
sucrion reservoir,at the sa me height as the pump. In order t o
realize different ECC circuir resistance, an adjusrable valve was
introduced downsrream the oxygenator, before rh e delivery
reservoir.The tubing circuir was made with a IO mm internai
diameter pipe, ofthe type commonly used for ECC at our Hos-
pital, fora totallength of about 2.6 m.
journal of Clinica[ Engineering November/December 1999 363
Figure 2: Thc mcasuring scction.
To determine pump performances,i.e. t o measure the pro-
vided pn:ssure an d tlow, a tr.tnsducer support (Fig.2) specifi-
cally designed of aluminum with t be inner surt:tce ofTetlon t o
reduce rnechanical an d electromagnetic int1uences, was directly
introduced in the pump circuit,in such a manner that flow
resistance induced by the pump-transducer support connec-
t io n could be avoided.The measuring section was provided
w i rh a strain gage diaphragm type pressure sensor (accuracy
< l mmHg, HOOIIz bandwidth at -3dB attenuation) ;md a
Ila l l effe c t flow transducer (accurJcy < 0.1 1/min).The pres-
sure signa! was conditioned by means of a
dynamic str.tin gage unit.The pressure ami
fio w signals w ere directly col!ected by an
!Jigh-speed automatic data acquisition con-
tro l unit controlled by a personal com-
puter via an IEEE-488 based generai pur-
pose interface board.The collected data
was sto re d onto magnetic support for !ater
manipulation, so as to give graphical rep-
n.:sentation of results.
800
?CO
GOQ
a;
x 500
E
E
value obtained with complete opened
val\e or. in any case, (b) over ''50 m m Hg.
Two K rype thermocouples (with a
global temperature measuring system ac-
curaq <O. 5o c) were utilized for record-
ing both test area temper.nure (T ) near
.tmh '
tbc measuring section.and delivered fluid
temperature (Tn.,,) \Ve positioned the
measuring junction directly inside the
pump outlet section: their signals w ere
gathered by the DAC. In p:lrticular, the
measured fluid temperature was utilizecl
(a) as a feedback par.tmeter to contro! the
fluid heater in order to assure the con-
stancy ofthe set temperature with an ac-
curacy of l o c ami (b) as contro! param-
eter for the beginning of the data acquisi-
tion once that the tluid reached a stable
pre-selected temperature value,i.e. the fluc-
tuations of tbc measured fluid tempera-
ture were confned in the r.mge ofthe pre-
viously mentioned inaccuracy.
The tests were conducted by utilizing different experi-
mental configurations, as summarized in Tab.l, with reference
to: (a) different fluids (more specifically w e test ed t be ECC
circuir by using disti!! ed water ami Emage!T.\1, which is a blood
substitute that best simulates hemodiluited blood densiry and
viscosiry,i.e. the fluid evolving during actual ECC utilization,
addressed in the following as"the fluid test");(b) different tem-
peramres, corresponding to the main opemtion conditions, i.e.
hypothermia at ISOC and normothermia at 37oc ("the tem-
2
( :onsidering the results obtained in the
prior phase of t be researc!J project [2H]
t Ile sample frequency was setto 500Hz;
tllc overall system bandwidth seemed to
h c suflcicnt. though narrow, considering
tllat witll the usual pump rotation speed,
hc;trt surgery in chi!dren detem1ines pres-
sure variations as functions of time whose
~ 100
"'
"' 300
(L
?.00
lCO
~
40rpm
20rpm
60rpm
t<40rpm
1 Waler
2: Emaqel
fund;tmcntal frequency is between 1 ami
5llz. In order not t o overload the hydrau-
lic circuir, i t was decided to automatically
S\Vitch off thc pump when the pressure
(a) increased up to about four times the
Flow [limi n]
Figure 3: Fluid tcst-Prcssurc vcrsus t7ow (or disti/led n:atcr and EmaacfTM at
~ s o c h ~
- wJt mcdllun occ!usion at various rpm.
364 Journal of Clinica l Engineering November/December 1999
eco
!'JJ
l CO
20rpm
80rpm
<40rpm
1: 37"C
2: 18"C
value. From an examination ofthis figure,
i t clearly emerges that the behavior of the
pump is detnitely different depending on
the fluid-dynamic characteristics of the
evolving tluid,sucil as densi[}' and viscos-
i[}', whose increases cause either the trans-
lation or sensiti\'iry shift of pump pressure-
flow relationship. Due to the previously
indicated results, i t decided to conduct
the remaining planned tests with
EmageJ'D
1
.

1l1e temper.nure test was performed
with the airn ofidentifying the relevance
of the dependence of flui d pressure an d
tlow values on the evolving tluid temper.l-
ture.Thus, the roller pump occlusion leve!
0
Flow [l/m/n]
\Vas set to medium and mean pressure-
tlow curves determined in condition
Figure 4: Temperature test-Pressure versus flow far Emagefnt a t 18 an d 3 ?DC
with medium occlusion at various rpm.
of hypothermia, ( l8C) an d normother-
mia (37C), see Fig.4; the gathered data
showed an uncertain[}' always less th:m6.6
pera tu re test"); a nel, tnally, (c) different occlusion leve! (''t h e
occlusion test").With reference to the occlusion leve!, i t is nec-
essary to outline that w e will referto: (a) a meclium occlusion,
as the setting corresponding to the usual pr.lctice a t our He:lrt-
Surgery Department, i. e. unscrewing the regulating knob a half
turn after a total occlusion of the pipe, (b) a rnaximum occlu-
sion, as the total occlusi o n of the pipe an d, finally, (c) a mini-
mum occlusion, obtained by o ne a nel one-half unscrewing of
the regulating knob from the maximum occlusion conclition.
Si x data sets were obtainecl for each experimental conclition
(i.e., fluid, temperature, occlusion leve! and pump rotation
speed).
Results And Discussion
l t was trst decided to experimentally evaluate the evolv-
ing fluid effects on pump performances by comparing the
results obtainecl by testing clistillecl water an d EmageJHI.The
ai m of this test was the verifcation ofthe viability of substitut-
ing a perishable tluid,as is Emagel, with distillecl water in the
other planned tests an cl, consequently, to clrastically simplify
percent ofthe relative full scale value.At a
glance, results show noticeable dependency on temper.nure;
in f.lct, a t high rotation speed, lower temper.m1re curves present
relevant right-translation. whereas sensitivity shift is more evi-
dent a t low rpm.1l1e observed behavior seems to be ascribed
to viscosity an d density clecrease with temperature ancl, as a
matter of fact, confrms the results seen in t be tluicl test.
Finally, the occlusion test was conclucted according t o the
setup indicatecl inTab.l.TI1e mean resuiL'> are reportecl in
(see Fig.5), with an uncertainry always less than 9.5 percent of
the relative full scale value for minimum occlusi o n setting while,
a t maximum occlusion, signitcanr recluction was observed (al-
ways less t han 2 percent of the relative full scale value).
In spite ofthe attenrion paid to the pump occlusion set-
ting, the observed uncertainty clecrease outlines that a greater
repeatability occurs in cases of complete occlusion, i.e. w ben
the knob is completely screwed.As expectecl, the occlusi o n
leve! is the most effective par.tmeter on flow-pressure rela-
tionship. For these curves, the most eviclent behavior is the
relevant change in sensitivity shift, even though a translation
t ile study. Therefore the test
was carried out at the same
temperature of 25C for bot h
t ile tluids ami by setting a me-
dium occlusion leve! for the
pump.The mean value curves
relative to the tluid test results
were determined, see Fig.3,
and the associated interval of
uncertainty for each graph
was always less than 7.2 per-
cent of the relative full scale
Tablc 1-Expcrimental configurations
Test type Test no. Temperature Flui d Occlusion leve!
Fluid test l 25C Distilled water Medium
2 25C EmagciTM ,\leclium
Temper.lture test 3 l8C Emageln
1
tvledium
4 3rc Emageln
1
Mec!ium
Occlusion test 5 25C Emageln
1
Minimum
6 25C Emageln
1
Maximum
Journal of Clinica! Engineering November/December 1999 365
7GJ
GCO
20rpm
\
20
1V0
40rpm
60 rpm
120rpm
100mrn
1: Minimum occlusJon
2: Max1mum OCCIUSJOn
Flow [l/m in]
lyzers, pulse o:-.:ymeters, etc. as is the usual
practice in operating theatre.
In the end, a further discussion with
t h e heart surgery staff o n the previously
indicated remarks caused them to concen-
trate their attention to ECC component
trimming.
Concluding Remarks
The performances of a peristaltic
Verticlude roller pump have been experi-
mentally evaluated for different working
conditions and the observed results al-
lowed for developing of graphs that ha ve
heen adopted by physicians at the Heart-
Surgery Department ofthe Chiklren's Hos-
pital "Bambino Gesil" as a reference for
proper pump settings. Furthermore, the
Figure 5: Occlusion test-Pressure versus flow {or EmagefTM at 25C with
minimum and maxinwm occlusions at various rpm.
obtained flow-pressure relationships as a
function of the examined parameters ca n
be effectively used for correct ECC circu t
design. Finally, as the observed high sensi-
proportional at rpm is also present. I t clearly emerges, as ex-
pected, that the maximum occlusion setting detem1ines quasi-
volumetric pump behavior.
The previous reported results, even though obtained by
testing only a few significant parameter values, allow us to
make the following observations. From a global analysis of t h e
curves i t is clear the curves obtained interpolating the mini-
mum values of the pressure versus fio w curve resulted in t h e
rc.:sistance curve of t h e utilized hyclraulic ECC circuir for each
test conclition. Moreover, the collected data indicate a signifi-
ca n t dependence of the pump performance on the investi-
gated parameters. rn particular, the relevant data spread in
nominally identica! test conditions does not re produce identi-
ca! pump test conditions, with reference either to them1o-fluid-
dynamic characteristics of the evolving flui d orto pump oc-
clusion setting.
The last mentionecl phenomenon illustrates the relevancy
of standardization of roller pump knob regulation procedures.
lt should also be remembered that the temperature setting
imposed by surgical neecls is the only parameter whose re-
sponsibility completely depends on t h e operator. Furthennore,
thc mean value curves show extremely different pump per-
formances arnong the examined test conditions.Thus, i t be-
com es necessary for in-line introduction of bot h the pressure
tr;msduccr, as already indicated in a previous phase of t h e re-
scarch [27j,aml the tlow transducer to continuously monitor
ECC working condition.ll1erefore, this is t h e only way t o a chieve
an cxact regulation of tlow parameters an d, as a consequence,
the monitoring of patient perfusion, when utilizing an addition
t o !ife parameters monitoring performed by means of ECG
monitor. multil.mction analyzers, capnometers, oxygen an a-
tivity of pump performances t o small working condition varia-
tion, with particular refe re n ce t o t h e occlusi o n leve l, can be cause
of severe damages to neonata! patients, therefore the results
hereby presented contributed to increase the perfusionist at-
tention t o more accurate pump settings.
Acknowledgments
TheAuthors wish to thank .John F lartlett an d Francesco
Rapanotti for their helpful support ami express their apprecia-
tion to t h e Clinica! Engineering Service an d the Heart-Surgery
Department of the Children 's H ospitai "Bambino Gesti'' ofRome
for the experimental faciliti es, cooperation ami assistance pro-
vided.
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)ournal of Clinica! Engineering November/December 1999 367