title: A novel device for reducing hemolysis provoked by cardiotomy suction during open heart cardiopulmonary bypass surgery: a randomized prospective study.
abstract: Since the inception of cardiopulmonary bypass (CPB), little progress has been made concerning the design of cardiotomy suction (CS). Because this is a major source of hemolysis, we decided to test a novel device (Smartsuction [SS]) specifically aimed at minimizing hemolysis during CPB in a clinical setting. Block randomization was carried out on a treated group (SS, n=28) and a control group (CTRL, n=26). Biochemical parameters were taken pre-, peri-, and post CPB and were compared between the two groups using the Student's t-test with statistical significance when P<0.05. No significant differences in patient demographics were observed between the two groups. Lactate dehydrogenase (LDH) and plasma free hemoglobin (PFH) pre-CPB were comparable for the CTRL and SS groups, respectively. LDH peri-CPB was 275+/-100 U/L versus 207+/-83 U/L for the CTRL and SS groups, respectively (P<0.05). PFH was 486+/-204 mg/L versus 351+/-176 mg/L for the CTRL and SS groups, respectively (P<0.05). LDH post CPB was 354+/-116 U/L versus 275+/-89 U/L for the CTRL and SS groups, respectively (P<0.05). PFH was 549+/-271 mg/L versus 460+/-254 mg/L for the CTRL and SS groups, respectively (P<0.05). Preoperative hematocrit (Hct) of 43+/-5% (CTRL) versus 37+/-5% (SS), and hemoglobin (Hb) of 141+/-16 g/L (CTRL) versus 122+/-17 g/L (SS) were significantly lower in the SS group. However, when normalized (N), the SS was capable of conserving Hct, Hb, and erythrocyte count perioperatively. Erythrocytes (N) were 59+/-5% (CTRL) versus 67+/-9% (SS); Hct (N) was 59+/-6% (CTRL) versus 68+/-9% (SS), and Hb (N) was 61+/-6% (CTRL) versus 70+/-10% (SS) (all P<0.05). This novel SS device evokes significantly lowered blood PFH and LDH values peri- and post CPB compared with the CTRL blood using a CS system. The SS may be a valuable alternative compared to traditional CS techniques.
authors.affiliation: Department of Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. David.Jegger@chuv.ch
authors.forename: David
authors.initials: D
authors.lastname: Jegger
authors.forename: Judith
authors.initials: J
authors.lastname: Horisberger
authors.forename: Mirko
authors.initials: M
authors.lastname: Jachertz
authors.forename: Isabelle
authors.initials: I
authors.lastname: Seigneul
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Tozzi
authors.forename: Dominique
authors.initials: D
authors.lastname: Delay
authors.forename: Ludwig K
authors.initials: LK
authors.lastname: von Segesser
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000295:instrumentation*; D005260:Female; D006355:Heart-Lung Machine / Q000009:adverse effects*; D006461:Hemolysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D013396:Suction / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods