Controlled cardiotomy suction during clinical bubble oxygenator perfusions

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Hematology

Background:

• Cardiotomy suction can cause platelet damage and hemolysis through air aspiration (uncontrolled suction, US).
• Controlled suction (CS) minimizes air aspiration, reducing these adverse effects, particularly with membrane oxygenators (MO).

Purpose of the Study:

• To compare the effects of controlled suction (CS) and uncontrolled suction (US) on platelet preservation and hemolysis during extracorporeal circulation using bubble oxygenators (BO) and membrane oxygenators (MO).

Main Methods:

• Patients undergoing extracorporeal circulation were divided into three groups: BO with CS (n=10), BO with US (n=8), and MO with US (n=10).
• Platelet count, ADP-induced platelet aggregation, beta-thromboglobulin levels, and blood loss were assessed.

Main Results:

• CS significantly reduced hemolysis compared to US in BO perfusions.
• Platelets were significantly better preserved with MO and US than with BO and CS, indicated by higher platelet counts, aggregation, and lower beta-thromboglobulin.
• No significant differences in blood loss or transfusion requirements were observed between the groups within 18 hours post-perfusion.

Conclusions:

• The platelet-protective benefits of CS are negated by the damaging effects of bubble oxygenators (BO).
• Membrane oxygenators (MO) offer superior platelet preservation, even with uncontrolled suction (US).
• Controlled suction (CS) effectively reduces hemolysis, irrespective of the oxygenator type.