Sizhe Gao1, Yongnan Li1,2, Xiaolin Diao3, Shujie Yan1, Gang Liu1, Mingyue Liu1, Qiaoni Zhang1, Wei Zhao3, Bingyang Ji1. 1. Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Medicine, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China. 2. Department of Cardiac Surgery, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, China. 3. Department of Information Center, State Key Laboratory of Cardiovascular Medicine, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
Abstract
OBJECTIVES: Conventional cardiopulmonary bypass with gravity drainage leads inevitably to haemodilution. Vacuum-assisted venous drainage (VAVD) utilizes negative pressure in the venous reservoir, allowing active drainage with a shortened venous line to reduce the priming volume. The goal of this study was to analyse the efficacy and safety of VAVD. METHODS: Data on 19 687 patients (18 681 with gravity drainage and 1006 with VAVD) who underwent cardiac operations between 1 January 2015 and 31 January 2018 were retrospectively collected from a single centre. Propensity matching identified 1002 matched patient pairs with VAVD and gravity drainage for comparison of blood product transfusion rate, major morbidities and in-hospital mortality rates. RESULTS: The blood transfusion rate of the VAVD group was lower than that of the gravity drainage group (28.1% vs 35% for red blood cells, 13% vs 18% for fresh frozen plasma and 0.1% vs 1.8% for platelets; P = 0.0009, 0.0020 and <0.0001, respectively). The mean difference (95% confidence interval) between the groups for red blood cells, fresh frozen plasma and platelets was -6.9% (-11.0% to -2.8%), -5.0% (-8.1% to -1.8%) and -1.7% (-2.5% to -0.9%), respectively. No difference was observed regarding the major morbidities of cerebrovascular accidents, acute kidney injury, hepatic failure and perioperative myocardial infarction and the in-hospital deaths between the 2 groups. CONCLUSIONS: VAVD was associated with a reduction in blood product transfusions, and an increase in the risk of major morbidities and in-hospital deaths of the VAVD group was not observed.
OBJECTIVES: Conventional cardiopulmonary bypass with gravity drainage leads inevitably to haemodilution. Vacuum-assisted venous drainage (VAVD) utilizes negative pressure in the venous reservoir, allowing active drainage with a shortened venous line to reduce the priming volume. The goal of this study was to analyse the efficacy and safety of VAVD. METHODS: Data on 19 687 patients (18 681 with gravity drainage and 1006 with VAVD) who underwent cardiac operations between 1 January 2015 and 31 January 2018 were retrospectively collected from a single centre. Propensity matching identified 1002 matched patient pairs with VAVD and gravity drainage for comparison of blood product transfusion rate, major morbidities and in-hospital mortality rates. RESULTS: The blood transfusion rate of the VAVD group was lower than that of the gravity drainage group (28.1% vs 35% for red blood cells, 13% vs 18% for fresh frozen plasma and 0.1% vs 1.8% for platelets; P = 0.0009, 0.0020 and <0.0001, respectively). The mean difference (95% confidence interval) between the groups for red blood cells, fresh frozen plasma and platelets was -6.9% (-11.0% to -2.8%), -5.0% (-8.1% to -1.8%) and -1.7% (-2.5% to -0.9%), respectively. No difference was observed regarding the major morbidities of cerebrovascular accidents, acute kidney injury, hepatic failure and perioperative myocardial infarction and the in-hospital deaths between the 2 groups. CONCLUSIONS: VAVD was associated with a reduction in blood product transfusions, and an increase in the risk of major morbidities and in-hospital deaths of the VAVD group was not observed.
Authors: Juan Blanco-Morillo; José María Arribas-Leal; Piero Farina; Angel Luis Fernández-González; Ángel Sornichero-Caballero; Pablo Ramírez-Romero; Tyler N Chen; Diego Salmerón-Martínez; Sergio Juan Cánovas-López Journal: J Extra Corpor Technol Date: 2021-03