| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2000;70:1296-1300
© 2000 The Society of Thoracic Surgeons
a Department of Cardiothoracic Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
b Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
c Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
Address reprint requests to Dr Hammon, Department of Cardiothoracic Surgery, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
e-mail: jhammon{at}wfubmc.edu
Presented at the Forty-sixth Annual Meeting of the Southern Thoracic Surgical Association, San Juan, Puerto Rico, Nov 4–6, 1999.
Background. Microembolization during cardiopulmonary bypass (CPB) can be detected in the brain as lipid deposits that create small capillary and arteriolar dilations (SCADs) with ischemic injury and neuronal dysfunction. SCAD density is increased with the use of cardiotomy suction to scavenge shed blood. Our purpose was to determine whether various methods of processing shed blood during CPB decrease cerebral lipid microembolic burden.
Methods. After hypothermic CPB (70 minutes), brain tissue from two groups of mongrel dogs (28 to 35 kg) was examined for the presence of SCADs. In the arterial filter (AF) group (n = 12), shed blood was collected in a cardiotomy suction reservoir and reinfused through the arterial circuit. Three different arterial line filters (Pall LeukoGuard, Pall StatPrime, Bentley Duraflo) were used alone and in various combinations. In the cell saver (CS) group (n = 12), shed blood was collected in a cell saver with intermittent preocessing (Medtronic autoLog model) or a continuous-action cell saver (Fresenius Continuous Auto Transfusion System) and reinfused with and without leukocyte filtration through the CPB circuit.
Results. Mean SCAD density (SCAD/cm2) in the CS group was less than the AF group (11 ± 3 vs 24 ± 5, p = 0.02). There were no significant differences in SCAD density with leukocyte filtration or with the various arterial line filters. Mean SCAD density for the continuous-action cell saver was 8 ± 2 versus 13 ± 5 for the intermittent-action device.
Conclusions. Use of a cell saver to scavenge shed blood during CPB decreases cerebral lipid microembolization.
Related Article
Ann. Thorac. Surg. 2000 70: 1300.
This article has been cited by other articles:
|
|
 |
|
  M. Boodhwani, H. J. Nathan, T. G. Mesana, F. D. Rubens, and Cardiotomy Investigators Effects of shed mediastinal blood on cardiovascular and pulmonary function: a randomized, double-blind study. Ann. Thorac. Surg., October 1, 2008; 86(4): 1167 - 1173. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Marcoux, M Rosin, E McNair, G Smith, H. Lim, and T Mycyk A comparison of intra-operative cell-saving strategies upon immediate post-operative outcomes after CPB-assisted cardiac procedures Perfusion, May 1, 2008; 23(3): 157 - 164. [Abstract] [PDF]
|
|
|
|
|
|
A. Eyjolfsson, S. Scicluna, P. Johnsson, F. Petersson, and H. Jonsson Characterization of Lipid Particles in Shed Mediastinal Blood Ann. Thorac. Surg., March 1, 2008; 85(3): 978 - 981. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. W. Hammon Extracorporeal Circulation: Perfusion System Card. Surg. Adult, January 1, 2008; 3(2008): 350 - 370. [Full Text]
|
|
|
|
|
|
J. W. Hammon Extracorporeal Circulation: Organ Damage Card. Surg. Adult, January 1, 2008; 3(2008): 389 - 414. [Full Text]
|
|
|
|
 |
|
 W. A. Baumgartner Neurocognitive Changes After Coronary Bypass Surgery Circulation, October 23, 2007; 116(17): 1879 - 1881. [Full Text] [PDF]
|
|
|
|
|
|
G. Djaiani, L. Fedorko, M. A. Borger, R. Green, J. Carroll, M. Marcon, and J. Karski Continuous-Flow Cell Saver Reduces Cognitive Decline in Elderly Patients After Coronary Bypass Surgery Circulation, October 23, 2007; 116(17): 1888 - 1895. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Appelblad and K. G. Engstrom Fat content in pericardial suction blood and the efficacy of spontaneous density separation and surface adsorption in a prototype system for fat reduction J. Thorac. Cardiovasc. Surg., August 1, 2007; 134(2): 366 - 372. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Motallebzadeh, J. M. Bland, H. S. Markus, J. C. Kaski, and M. Jahangiri Neurocognitive Function and Cerebral Emboli: Randomized Study of On-Pump Versus Off-Pump Coronary Artery Bypass Surgery Ann. Thorac. Surg., February 1, 2007; 83(2): 475 - 482. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Castiglioni, A. Verzini, F. Pappalardo, N. Colangelo, L. Torracca, A. Zangrillo, and O. Alfieri Minimally Invasive Closed Circuit Versus Standard Extracorporeal Circulation for Aortic Valve Replacement Ann. Thorac. Surg., February 1, 2007; 83(2): 586 - 591. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. J Lilly, J. M Balaguer, P. A Pirundini, M. A Smith, G. Connelly, L. J. Campbell, P. C Philie, M. McAdams, W. Riley, R. Dekkers, et al. Early results of a comprehensive operative and perfusion strategy to attenuate the incidence of adverse neurological outcomes in on-pump coronary artery bypass grafting (CABG) patients Perfusion, November 1, 2006; 21(6): 311 - 317. [Abstract] [PDF]
|
|
|
|
|
|
K. G. Shann, D. S. Likosky, J. M. Murkin, R. A. Baker, Y. R. Baribeau, G. R. DeFoe, T. A. Dickinson, T. J. Gardner, H. P. Grocott, G. T. O'Connor, et al. An evidence-based review of the practice of cardiopulmonary bypass in adults: A focus on neurologic injury, glycemic control, hemodilution, and the inflammatory response. J. Thorac. Cardiovasc. Surg., August 1, 2006; 132(2): 283 - 290.e3. [Full Text] [PDF]
|
|
|
|
|
|
M. Carrier, A. Denault, J. Lavoie, and L. P. Perrault Randomized controlled trial of pericardial blood processing with a cell-saving device on neurologic markers in elderly patients undergoing coronary artery bypass graft surgery. Ann. Thorac. Surg., July 1, 2006; 82(1): 51 - 55. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. W. Hogue Jr, C. A. Palin, and J. E. Arrowsmith Cardiopulmonary bypass management and neurologic outcomes: an evidence-based appraisal of current practices. Anesth. Analg., July 1, 2006; 103(1): 21 - 37. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J W Mulholland The Great Britain and Ireland perspective: current perfusion safety issues, preparing for the future Perfusion, July 1, 2005; 20(4): 217 - 225. [Abstract] [PDF]
|
|
|
|
 |
|
 K. Prasongsukarn and M. A. Borger Reducing Cerebral Emboli During Cardiopulmonary Bypass Seminars in Cardiothoracic and Vascular Anesthesia, June 1, 2005; 9(2): 153 - 158. [Abstract] [PDF]
|
|
|
|
|
|
R. Motallebzadeh and M. Jahangiri Distinguishing solid from gaseous emboli during cardiac surgery J. Thorac. Cardiovasc. Surg., May 1, 2005; 129(5): 1194 - 1194. [Full Text] [PDF]
|
|
|
|
|
|
H. Jonsson, A. Nilsson, F. Petersson, M. Allers, and T. Laurell Particle separation using ultrasound can be used with human shed mediastinal blood Perfusion, January 1, 2005; 20(1): 39 - 43. [Abstract] [PDF]
|
|
|
|
|
|
S Svenmarker, K G Engstrom, T Karlsson, E Jansson, R Lindholm, and T Aberg Influence of pericardial suction blood retransfusion on memory function and release of protein S100B Perfusion, December 1, 2004; 19(6): 337 - 343. [Abstract] [PDF]
|
|
|
|
|
|
H. Jonsson, C. Holm, A. Nilsson, F. Petersson, P. Johnsson, and T. Laurell Particle Separation Using Ultrasound Can Radically Reduce Embolic Load to Brain After Cardiac Surgery Ann. Thorac. Surg., November 1, 2004; 78(5): 1572 - 1577. [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]
|
|
|
|
 |
|
 D. C. Whitaker, S. P. Newman, J. Stygall, C. Hope-Wynne, M. J.G. Harrison, and R. K. Walesby The effect of leucocyte-depleting arterial line filters on cerebral microemboli and neuropsychological outcome following coronary artery bypass surgery Eur. J. Cardiothorac. Surg., February 1, 2004; 25(2): 267 - 274. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. G. Engstrom Contaminating fat in pericardial suction blood: a clinical, technical and scientific challenge Perfusion, January 1, 2004; 19(1_suppl): S21 - S31. [Abstract] [PDF]
|
|
|
|
|
|
J. M. Albes, I. M. Stohr, M. Kaluza, A. Siegemund, D. Schmidt, R. Vollandt, and T. Wahlers Physiological coagulation can be maintained in extracorporeal circulation by means of shed blood separation and coating J. Thorac. Cardiovasc. Surg., November 1, 2003; 126(5): 1504 - 1512. [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]
|
|
|
|
|
|
A. K. Kaza, J. T. Cope, S. M. Fiser, S. M. Long, J. A. Kern, I. L. Kron, and C. G. Tribble Elimination of fat microemboli during cardiopulmonary bypass Ann. Thorac. Surg., February 1, 2003; 75(2): 555 - 559. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. G. Engstrom and M. Appelblad Fat reduction in pericardial suction blood by spontaneous density separation: an experimental model on human liquid fat versus soya oil Perfusion, January 1, 2003; 18(1): 39 - 45. [Abstract] [PDF]
|
|
|
|
|
|
E. A. Hessel II and L. H. Edmunds Jr. Extracorporeal Circulation: Perfusion Systems Card. Surg. Adult, January 1, 2003; 2(2003): 317 - 338. [Full Text]
|
|
|
|
|
|
J. W. Hammon Jr. and L. H. Edmunds Jr. Extracorporeal Circulation: Organ Damage Card. Surg. Adult, January 1, 2003; 2(2003): 361 - 388. [Full Text]
|
|
|
|
|
|
K. G. Engstrom The embolic potential of liquid fat in pericardial suction blood, and its elimination Perfusion, January 1, 2003; 18(1_suppl): 69 - 74. [Abstract] [PDF]
|
|
|
|
|
|
T. W. Willcox and R. van Uden Best Practice for Cardiopulmonary Bypass in the High-Risk Elderly Patient Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2002; 6(4): 293 - 300. [Abstract] [PDF]
|
|
|
|
|
|
M. Appelblad and G. Engstrom Fat contamination of pericardial suction blood and its influence on in vitro capillary-pore flow properties in patients undergoing routine coronary artery bypass grafting J. Thorac. Cardiovasc. Surg., August 1, 2002; 124(2): 377 - 386. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Capdeville and J. H. Lee Off-Pump Coronary Artery Bypass Surgery: Revival of an Old Technique Seminars in Cardiothoracic and Vascular Anesthesia, November 1, 2001; 5(4): 345 - 361. [Abstract] [PDF]
|
|
|
|
|
|
J. M. Murkin Attenuation of neurologic injury during cardiac surgery Ann. Thorac. Surg., November 1, 2001; 72(5): S1838 - 1844. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L.-C. Hsu Heparin-coated cardiopulmonary bypass circuits: current status Perfusion, September 1, 2001; 16(5): 417 - 428. [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 |
