Hemolysis at Different Vacuum Levels during Vacuum-Assisted Venous Drainage: A Prospective Randomized Clinical Trial

Göksedef, Deniz; Balkanay, Ozan Onur; Yalvaç, Ethem Serdar; Talas, Zeki; Albayrak, Asya; İpek, Gökhan

doi:10.1055/s-0031-1280019

Cited by 23 publications

(20 citation statements)

References 18 publications

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“…As the ECC becomes an arteriovenous extension of the patient's vascular network, the arterial flow and venous flow of the ECC must be in equilibrium. This constant ensures an adequate arteriovenous systemic flow capable of satisfying the patient's physiological needs during ECC [18][19][20][21][22].…”

Section: Optimisation Of the Circuit And The Cpb Console With A Holdementioning

confidence: 99%

Holder System for External Pumps Positioned Remote from the CPB Console: 23 Years’ Experience

Borrelli¹,

Detroux²,

Nottin³

et al. 2019

Advances in Extra-Corporeal Perfusion Therapies

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Since 1995, our objective is to set up the extracorporeal circulation (ECC) in a manner that is both safe and versatile with a holder system which makes possible to install the oxygenator and vacuum-assisted venous drainage (VAVD) hard-shell venous reservoir (HSVR) together with the external pumps, at a distance from the cardiopulmonary bypass (CPB) console but at the same height as the patient's shoulder. The aim is to reduce the effects of ECC by reducing surface of air/blood, blood/materials contact, the dead space of the system and priming volume of the circuit. Our ECC systems have a biocompatible surface treatment, the oxygenator and HSVR are adapted to the patient (body surface area, pathologies, etc.) and circuit includes short 3/8 in arterial and venous line (adult patients). We introduced into routine VAVD, retrograde autologous priming (RAP), including arterial line, arterial filter and antegrade autologous priming of the venous line (VAP) before the start of ECC. To confirm this development strategy of the ECC, we conducted a series of studies that have permitted to demonstrate the positive impact on postoperative outcomes of patients. Since September 2007, our objective was attained through the creation of a holder system (System U. Borrelli).

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Section: Optimisation Of the Circuit And The Cpb Console With A Holdementioning

confidence: 99%

Holder System for External Pumps Positioned Remote from the CPB Console: 23 Years’ Experience

Borrelli¹,

Detroux²,

Nottin³

et al. 2019

Advances in Extra-Corporeal Perfusion Therapies

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“…Roller pump, kinetic, and vacuum-assisted venous drainage have been reported, each with unique considerations for cardiopulmonary bypass [119][120][121][122][123][124][125][126][127][128][129][130][131][132][133]. Venous return is visually monitored through out the bypass run and quantified by changes in the venous reservoir level.…”

Section: Standard and Augmented Venous Returnmentioning

confidence: 99%

“…VAVD increases the external arterial line filter purge and/or sampling line shunt flow and increases the rate of transfusion when adding volume to the reservoir (blood, crystalloid and medications) [124]. And, excessive negative pressure may damage the formed elements of the blood [127]. Further, the displayed roller head arterial pump output may be inaccurate with negative pressure values below −50 mmHg [126].…”

Section: Vacuum-assisted Venous Drainagementioning

confidence: 99%

The bypass plan

Matte

2015

Perfusion for Congenital Heart Surgery

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The perfusionist must be familiar with the patient's original diagnosis, catheterization lab interventions, previous surgeries, and current needs when developing the bypass plan. The following are major considerations for management of the patient during cardiopulmonary bypass. Please refer to Chapter 6 for defect-specific considerations.The care team must have a reasonably standardized communication plan for the bypass run [1][2][3]. This includes standardizing to closed-loop communication for certain anesthesia, surgical, and cardiopulmonary bypass (CPB) commands, notifications, and/or concerns. Each communication should be verbally acknowledged per the team standard (either repeated back or with another affirmation) to ensure the information is properly delivered and handled. This technique is essential for bypass safety and is used at most centers to announce checkpoints during the case.Common bypass-related checkpoints where closedloop communication among the team is essential include the following: • Heparin in • ACT running • Bypass lines clamped and ready for division at the field • Pump suckers on (with suckers and vent line tested under saline at field)

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“…2 However, we should be careful when applying negative pressure because excessive negative pressure may induce air embolism in the circuit [3][4][5][6] or hemolysis. 7,8 Many important studies have examined these problems; however, few studies have suggested a safe negative pressure to minimize hemolysis in infants. Therefore, we examined the hemolysis associated with negative pressure during VAVD maneuver in the perioperative period in children weighing less than 10 kg.…”

Section: Introductionmentioning

confidence: 99%

Hemolysis During Open-Heart Surgery With Vacuum-Assisted Venous Drainage at Different Negative Pressures in Pediatric Patients Weighing Less Than 10 kilograms

Kwak

Lee

Park

et al. 2017

World J Pediatr Congenit Heart Surg

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In pediatric patients weighing less than 10 kg, the change in the degree of hemolysis did not differ with the amount of negative pressure. We may apply negative pressures up to 60 mm Hg without increasing the risk of hemolysis, with almost same the level of hemolysis using negative pressures of 20, 30, and 40 mm Hg for effective venous drainage and an ideal operative field during open-heart surgery.

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Hemolysis at Different Vacuum Levels during Vacuum-Assisted Venous Drainage: A Prospective Randomized Clinical Trial

Abstract: Constant negative suction at -80 mmHg during elective coronary bypass operations caused more hemolysis. We do not recommend a constant suction of -80 mmHg for VAVD.

Cited by 23 publications

References 18 publications

Holder System for External Pumps Positioned Remote from the CPB Console: 23 Years’ Experience

Holder System for External Pumps Positioned Remote from the CPB Console: 23 Years’ Experience

The bypass plan

Hemolysis During Open-Heart Surgery With Vacuum-Assisted Venous Drainage at Different Negative Pressures in Pediatric Patients Weighing Less Than 10 kilograms

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