Improving hemolysis levels associated with cardiotomy suction

Abstract

Background: The major source of hemolysis during cardiopulmonary bypass (CPB) remains the cardiotomy suction.¹ Previous research has shown that the combination of negative pressures and the massive air-blood interface exponentially increases hemolysis in suctioned blood.

Objective: This research aims to decrease hemolysis by eliminating the air-to-blood interface by implementing the Venturi effect to create powerful suction. This research effort hypothesizes that the Venturi suction will result in less hemolysis, indicated by lower plasma free hemoglobin levels (PFH) compared to current vacuum suction.

Method: The research hypothesizes that a paradigm approach to cardiotomy suction that utilizes the Venturi effect with shorter tubing lengths and weighted sucker tips will further reduce hemolysis.

Results: The vacuum-suctioned blood showed PFH levels significantly increased from baseline levels (p=0.0039). Neither the Venturi nor paradigm groups showed PFH levels significantly increased from baseline levels (p=0.0625 and p=0.125, respectively). There was a significant difference in PFH levels among the three conditions (p<0.0001). The vacuum condition showed significantly higher levels of PFH compared to both the Venturi and the paradigm conditions (p<0.001 for both). There was no significant difference in the PFH levels between the Venturi and the paradigm groups (p=1.00).

Conclusion: This study concludes that vacuum suction causes excessive hemolysis. A Venturi-powered suction system does not cause hemolysis and can be employed to reduce the damaging effects of vacuum suction on blood.

Keywords: Venturi; cardiopulmonary bypass; cardiotomy suction; hemolysis; plasma free hemoglobin.