Abstract
The evolution of cardiopulmonary bypass (CPB) techniques has been significantly enhanced by the integration of vacuum-assisted venous drainage (VAVD). Vacuum-assisted venous drainage improves venous return in minimally invasive, paediatric, and complex cardiac surgeries by reducing priming volumes and minimizing hemodilution. However, excessive negative pressure can lead to risks, such as air embolism, hemolysis, and circuit collapse. This study aimed to compare automated and manual (conventional) VAVD systems regarding key safety and performance parameters: (1) pressure stability under varying venous return conditions, (2) incidence of air embolism and vacuum-related complications, (3) alarm response times, and (4) hemolysis. A survey was conducted across 23 cardiac surgery centres, although 3 centres did not specify the type of VAVD device used and were excluded from data analysis. The final analysis included 20 centres: 10 using automated systems and 10 using conventional systems. Data were collected using a standardized checklist assessing real-time vacuum control, safety alarms, and complication rates. Results demonstrated that automated VAVD systems provided more consistent pressure stability (98%), reduced hemolysis rates (<3%), improved alarm response times (<2 seconds), and fewer air embolism events compared to manual systems.