Interactive cardiovascular and thoracic surgery · 2020
Vacuum-assisted venous drainage in adult cardiac surgery: a propensity-matched study.
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Gao Sizhe, Li Yongnan, Diao Xiaolin, Yan Shujie, Liu Gang, Liu Mingyue, Zhang Qiaoni, Zhao Wei, Ji Bingyang
Аннотация
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.
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.