title: Hemolysis at different vacuum levels during vacuum-assisted venous drainage: a prospective randomized clinical trial.
abstract: BACKGROUND
  There are several reports on the application of variable degrees of vacuum pressure to hardshell venous reservoirs. The aim of the current study was to compare the hemolytic effects of vacuum-assisted venous drainage (VAVD) at two different vacuum levels with the classical gravity siphon method.
  
  
  METHODS
  A prospective, equally randomized (1: 1: 1), parallel group study was performed in elective coronary artery bypass grafting (CABG) operations.
  
  
  METHODS
  (n = 162) were divided into three groups: gravity siphon (group 1, n = 55), VAVD at -40 mmHg (group 2, n = 55) and VAVD at -80 mmHg (group 3, n = 52). Hemolysis tests were performed at 2, 24 and 48 h following the operations.
  
  
  RESULTS
  There were no deaths in this study. Plasma-free hemoglobin (PfHb) levels showed a difference at 2 h (p < 0.001) compared to 24 h (p = 0.02) between the groups. Haptoglobin (Hp) levels also revealed hemolysis in groups 2 and 3 at all sampling times.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiovascular Surgery, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey. denizgoksedef@yahoo.com
authors.forename: D
authors.initials: D
authors.lastname: Goksedef
authors.forename: S N
authors.initials: SN
authors.lastname: Omeroglu
authors.forename: O O
authors.initials: OO
authors.lastname: Balkanay
authors.forename: E S
authors.initials: ES
authors.lastname: Denli Yalvac
authors.forename: Z
authors.initials: Z
authors.lastname: Talas
authors.forename: A
authors.initials: A
authors.lastname: Albayrak
authors.forename: G
authors.initials: G
authors.lastname: Ipek
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000379:methods; D016009:Chi-Square Distribution; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D004322:Drainage / Q000009:adverse effects*; D017558:Elective Surgical Procedures; D005260:Female; D006242:Haptoglobins / Q000378:metabolism; D006454:Hemoglobins / Q000378:metabolism; D006461:Hemolysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D013997:Time Factors; D014421:Turkey; D014618:Vacuum; D014680:Veins
chemical_list: D015415:Biomarkers; C485359:HP protein, human; D006242:Haptoglobins; D006454:Hemoglobins