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Eur J Cardiothorac Surg 2001;19:507-511
© 2001 Elsevier Science NL

Smart suction device for less blood trauma: a comparison with Cell Saver

Clinic for Cardiovascular Surgery and Surgical Intensive Care Unit, CHUV (Centre Hospitalier Universitaire Vaudois), CH-1011 Lausanne, Switzerland

Received 12 October 2000; received in revised form 25 January 2001; accepted 16 February 2001.

Corresponding author.Tel.: +41-21-314-2313; fax: +41-21-314-2278
e-mail: xavier.mueller{at}chuv.hospvd.ch

Objective: The major source of hemolysis during cardiopulmonary bypass remains the cardiotomy suction and is primarily due to the interaction between air and blood. The Smart suction system involves an automatically controlled aspiration designed to avoid the mixture of blood with air. This study was set-up to compare this recently designed suction system to a Cell Saver system in order to investigate their effects on blood elements during prolonged intrathoracic aspiration. Methods: In a calf model (n=10; mean weight, 69.3±4.5 kg), a standardized hole was created in the right atrium allowing a blood loss of 100 ml/min, with a suction cannula placed into the chest cavity into a fixed position during 6 h. The blood was continuously aspirated either with the Smart suction system (five animals) or the Cell Saver system (five animals). Blood samples were taken hourly for blood cell counts and biochemistry. Results: In the Smart suction group, red cell count, plasma protein and free hemoglobin levels remained stable, while platelet count exhibited a significant drop from the fifth hour onwards (prebypass: 683±201*10⁹/l, 5 h: 280±142*10⁹/l, P=0.046). In the Cell Saver group, there was a significant drop of the red cell count from the third hour onwards (prebypass: 8.6±0.9*10¹²/l, 6 h: 6.3±0.4*10¹²/l, P=0.02), of the platelet count from the first hour onwards (prebypass: 630±97*10⁹/l, 1 h: 224±75*10⁹/l, P<0.01), and of the plasma protein level from the first hour onwards (prebypass: 61.7±0.6 g/l, 1 h: 29.3±9.1 g/l, P<0.01). Conclusions: In this experimental set-up, the Smart suction system avoids damage to red cells and affects platelet count less than the Cell Saver system which induces important blood cell destruction, as any suction device mixing air and blood, as well as severe hypoproteinemia with its metabolic, clotting and hemodynamic consequences.

Key Words: Cardiopulmonary bypass • Hemolysis • Blood • Suction

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