| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1999;68:58-62
© 1999 The Society of Thoracic Surgeons
a Department of Cardiothoracic Surgery, University Hospital, Würzburg, Germany
b Department of Microbiology, University Hospital, Würzburg, Germany
Address reprint requests to Dr Reents, Klinik und Poliklinik für Herz- und Thoraxchirurgie, Josef-Schneider-Str 6, D-97080 Würzburg, Germany
Background. Cardiopulmonary bypass causes a systemic inflammatory response and impaired hemostasis. We investigated whether intraoperative blood salvage with the cardiotomy suction contributes to these alterations. Furthermore, an alternative autotransfusion device (Haemonetics cell-saving device) was examined.
Methods. In 10 patients, interleukin-6, interleukin-8, tumor necrosis factor-
, thrombin-antithrombin complex, plasmin-antiplasmin complex, free hemoglobin, and the percentage of CD62+ thrombocytes were determined in the systemic circulation during cardiopulmonary bypass, in the cardiotomy suction tube, and in the blood from the cell-saving device. Additionaly, bacterial contamination was examined.
Results. Median levels of interleukin-6 (52 versus 10 µg/L; p = 0.005), interleukin-8 (26 versus 20 µg/L; p = 0.017), tumor necrosis factor- (24 versus 1 µg/L; p = 0.005), thrombin-antithrombin complex (113 versus 43 µg/L; p = 0.005), plasmin-antiplasmin complex (566 versus 489 µg/L; p = 0.022), and free hemoglobin (61 versus 30 mg/dL; p = 0.005) were higher in the cardiotomy suction tube compared with the systemic circulation. After processing the blood from the cell-saving device, interleukin-8, thrombin-antithrombin complex, and free hemoglobin remained above reference range, and in 90% of the cases bacterial contamination was observed.
Conclusions. Cardiotomy suction additionally contributes to the release of proinflammatory cytokines, activation of coagulation, and hemolysis. Because blood salvage with a Haemonetics cell-saving device led to normalization of some, but not all, parameters and bacterial contamination was common, the alternative use seems at least questionable.
This article has been cited by other articles:
|
|
 |
|
  The Society of Thoracic Surgeons Blood Conservatio, V. A. Ferraris, S. P. Ferraris, S. P. Saha, E. A. Hessel II, C. K. Haan, B. D. Royston, C. R. Bridges, R. S.D. Higgins, G. Despotis, et al. Perioperative Blood Transfusion and Blood Conservation in Cardiac Surgery: The Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists Clinical Practice Guideline Ann. Thorac. Surg., May 1, 2007; 83(5_Supplement): S27 - S86. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. J. Allen, W. T. McBride, T. J. McMurray, A. S. Phillips, S. P. Penugonda, G. Campalani, I. S. Young, and M. A. Armstrong Cell Salvage Alters the Systemic Inflammatory Response After Off-Pump Coronary Artery Bypass Grafting Surgery Ann. Thorac. Surg., February 1, 2007; 83(2): 578 - 585. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Niranjan, G. Asimakopoulos, A. Karagounis, G. Cockerill, M. Thompson, and V. Chandrasekaran Effects of cell saver autologous blood transfusion on blood loss and homologous blood transfusion requirements in patients undergoing cardiac surgery on- versus off-cardiopulmonary bypass: a randomised trial. Eur. J. Cardiothorac. Surg., August 1, 2006; 30(2): 271 - 277. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Westerberg, J. Gabel, A. Bengtsson, J. Sellgren, O. Eidem, and A. Jeppsson Hemodynamic effects of cardiotomy suction blood J. Thorac. Cardiovasc. Surg., June 1, 2006; 131(6): 1352 - 1357. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M J ten Brinke, P W Weerwind, S Teerenstra, J C. Feron, W van der Meer, and M H. Brouwer Leukocyte removal efficiency of cell-washed and unwashed whole blood: an in vitro study Perfusion, December 1, 2005; 20(6): 335 - 341. [Abstract] [PDF]
|
|
|
|
|
|
G.J. Murphy, C.S. Rogers, W.B. Lansdowne, I. Channon, H. Alwair, A. Cohen, M. Caputo, and G.D. Angelini Safety, efficacy, and cost of intraoperative cell salvage and autotransfusion after off-pump coronary artery bypass surgery: A randomized trial J. Thorac. Cardiovasc. Surg., July 1, 2005; 130(1): 20 - 28. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Wippermann, J. M. Albes, M. Hartrumpf, M. Kaluza, R. Vollandt, R. Bruhin, and T. Wahlers Comparison of minimally invasive closed circuit extracorporeal circulation with conventional cardiopulmonary bypass and with off-pump technique in CABG patients: selected parameters of coagulation and inflammatory system Eur. J. Cardiothorac. Surg., July 1, 2005; 28(1): 127 - 132. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Westerberg, A. Bengtsson, and A. Jeppsson Coronary surgery without cardiotomy suction and autotransfusion reduces the postoperative systemic inflammatory response Ann. Thorac. Surg., July 1, 2004; 78(1): 54 - 59. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. J. de Vries, Y. J. Gu, Y. L. Douglas, W. J. Post, H. Lip, and W. van Oeveren Clinical evaluation of a new fat removal filter during cardiac surgery Eur. J. Cardiothorac. Surg., February 1, 2004; 25(2): 261 - 266. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Biglioli, A. Cannata, F. Alamanni, M. Naliato, M. Porqueddu, M. Zanobini, E. Tremoli, and A. Parolari Biological effects of off-pump vs. on-pump coronary artery surgery: focus on inflammation, hemostasis and oxidative stress Eur. J. Cardiothorac. Surg., August 1, 2003; 24(2): 260 - 269. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. E. Jewell, E. F. Akowuah, S. K. Suvarna, P. Braidley, D. Hopkinson, and G. Cooper A prospective randomised comparison of cardiotomy suction and cell saver for recycling shed blood during cardiac surgery Eur. J. Cardiothorac. Surg., April 1, 2003; 23(4): 633 - 636. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. S. Aldea, L. O. Soltow, W. L. Chandler, C. M. Triggs, C. R. Vocelka, G. I. Crockett, Y. T. Shin, W. E. Curtis, and E. D. Verrier Limitation of thrombin generation, platelet activation, and inflammation by elimination of cardiotomy suction in patients undergoing coronary artery bypass grafting treated with heparin-bonded circuits J. Thorac. Cardiovasc. Surg., April 1, 2002; 123(4): 742 - 755. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T Amand, J Pincemail, F Blaffart, R Larbuisson, R Limet, and J O Defraigne Levels of inflammatory markers in the blood processed by autotransfusion devices during cardiac surgery associated with cardiopulmonary bypass circuit Perfusion, March 1, 2002; 17(2): 117 - 123. [Abstract] [PDF]
|
|
|
|
|
|
M H Cross Autotransfusion in cardiac surgery Perfusion, September 1, 2001; 16(5): 391 - 400. [Abstract] [PDF]
|
|
|
|
|
|
N. Tabuchi, M. Sunamori, T. Koyama, and A. Shibamiya Remaining procoagulant property of wound blood washed by a cell-saving device Ann. Thorac. Surg., May 1, 2001; 71(5): 1749 - 1749. [Full Text] [PDF]
|
|
|
|
|
|
W. Reents, J. Babin-Ebell, and O. Elert Remaining procoagulant property of wound blood washed by a cell-saving device: Reply Ann. Thorac. Surg., May 1, 2001; 71(5): 1749 - 1750. [Full Text] [PDF]
|
|
|
|
|
|
J W Mulholland, W Massey, and J C Shelton Investigation and quantification of the blood trauma caused by the combined dynamic forces experienced during cardiopulmonary bypass Perfusion, December 1, 2000; 15(6): 485 - 494. [Abstract] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
