Insight Into Kidney Protection by Vacuum-Assisted Venous Drainage in Adult Cardiac Operation　― A Multicenter Study

• Published in: Circulation Journal 2023/03/24, Vol.87(4), pp.551-559
• Main Authors: Wang, Lei, Zhang, Li Juan, Liu, Jing, Hu, Ji Feng, Xiao, Li Qiong, Chen, Xin
• Format: Article
• Language: English
• Subjects: Acute kidney injury; Acute Kidney Injury - etiology; Acute Kidney Injury - prevention & control; Adult; Cardiac Surgical Procedures - adverse effects; Cardiopulmonary bypass; Cardiopulmonary Bypass - adverse effects; Cardiovascular surgery; Drainage - adverse effects; Drainage - methods; Humans; Hyperemia; Kidney; Retrospective Studies; Vacuum-assisted venous drainage; Venous congestion
• ISSN: 1346-9843; 1347-4820; 1347-4820
• DOI: 10.1253/circj.CJ-22-0308

Background: The relationship between venous congestion and acute kidney injury (AKI) in cardiac surgery after cardiopulmonary bypass has not thoroughly investigated. Vacuum-assisted venous drainage (VAVD) reduces venous congestion, so we hypothesized that it would reduce the incidence of AKI in cardiovascular surgery.Methods and Results: We used a retrospective propensity score-matched analysis to evaluate the effect of VAVD on AKI in adult patients undergoing cardiac surgery. The primary outcomes were AKI and renal replacement therapy (RRT). Multivariable logistic regression was used to explore the association between VAVD exposure and adverse kidney outcomes. Of 15,387 eligible subjects, 13,480 and 1,907 had gravity drainage (GD) or VAVD, respectively, during cardiopulmonary bypass. On the basis of propensity scores, there were 1,468 matched patient pairs for GD and VAVD. The average central venous pressure (CVP) in the GD group was higher than in the VAVD group (4.43±1.23 mmHg vs. 2.30±0.98 mmHg, P