The effect of vacuum-assisted venous drainage on hemolysis during cardiopulmonary bypass

In cardiac surgery, systemic venous drainage is provided by gravity. During the procedure, the amount of venous drainage can be increased by using a vacuum-assisted venous drainage (VAVD) technique. The purpose of this study is to compare the effects of VAVD and gravitational drainage (GD) techniques on hemolysis.

Totally, 60 patients were included in the study. The patients were separated into three groups, and each group designed with 20 patients: Groups are defined as Group 1 (-40 mmHg VAVD), Group 2 (-60 mmHg VAVD), and Group 3 (GD). Preoperative and postoperative values of lactate dehydrogenase (LDH), haptoglobin (Hpt), mean platelet volume (MVP), and platelet count (Plt) were evaluated.

The duration of cardiopulmonary bypass, cross-clamp, and vacuum assistance times were similar in all groups (P > 0.05), whereas Group GD required more additional volume to maintain adequate perfusion (P = 0.034). Preoperative and postoperative measurements showed no significant difference in terms of LDH, MVP, Plt, and Hpt among the groups (P > 0.05).

There was no significant increase in hemolysis among the groups, which demonstrates that the VAVD technique, even if lower negative pressure is preferred, can be applied safely and effectively to improve venous drainage and consequently, cardiac decompression, even if smaller venous cannulas are used, and also avoid from superfluous fluid addition to sustain adequate extracorporeal perfusion.