Optimizing venous drainage using an ultrasonic flow probe on the venous line

Area of Science:

• Cardiovascular Surgery
• Perfusion Technology
• Medical Device Monitoring

Background:

• Minimally invasive surgery and miniaturized cardiopulmonary bypass (CPB) require augmented venous drainage.
• Vacuum-assisted venous drainage (VAVD) is commonly used but has known side effects like gaseous microemboli and venous line chatter.
• Traditional VAVD monitoring relies on arterial output, venous line chatter, and reservoir levels.

Purpose of the Study:

• To evaluate the impact of monitoring venous line flow rates on VAVD practices and side effects.
• To determine if direct venous flow monitoring optimizes VAVD vacuum pressure.
• To assess the potential reduction of VAVD-related complications.

Main Methods:

• Implementation of a second ultrasonic flow probe on the venous line for real-time flow rate monitoring in CPB cases.
• Review of clinical practice and VAVD parameters by staff perfusionists after 12 months of monitoring.
• Empiric observation of vacuum pressure requirements and VAVD side effects.

Main Results:

• Monitoring venous line flow rates led to a reduction in the overall vacuum pressure needed during CPB.
• This novel monitoring approach facilitated the provision of optimal vacuum levels.
• Empiric observations suggest a potential decrease in VAVD-associated side effects.

Conclusions:

• Direct monitoring of venous line flow rates is a valuable tool in managing VAVD.
• Optimizing vacuum levels through venous flow monitoring may mitigate known VAVD complications.
• This practice enhances the safety and efficacy of CPB in pediatric cardiothoracic surgery.