Coronary artery surgery: cardiotomy suction or cell salvage?

doi:10.1186/1749-8090-2-46

Review

. 2007 Oct 25:2:46.

doi: 10.1186/1749-8090-2-46.

Coronary artery surgery: cardiotomy suction or cell salvage?

Kelvin Lau¹, Hetul Shah, Andrea Kelleher, Neil Moat

Affiliations

PMID: 17961227
PMCID: PMC2173896
DOI: 10.1186/1749-8090-2-46

Review

Coronary artery surgery: cardiotomy suction or cell salvage?

Kelvin Lau et al. J Cardiothorac Surg. 2007.

. 2007 Oct 25:2:46.

doi: 10.1186/1749-8090-2-46.

Authors

Kelvin Lau¹, Hetul Shah, Andrea Kelleher, Neil Moat

Affiliation

¹ Department of Cardiac Surgery, Royal Brompton Hospital, and NHLI at Imperial College, London SW3 6NP, UK. kelvin.lau@uhl-tr.nhs.uk

PMID: 17961227
PMCID: PMC2173896
DOI: 10.1186/1749-8090-2-46

Abstract

Coronary artery bypass grafting (CABG) today results in what may be regarded as acceptable levels of blood loss with many institutions avoiding allogeneic red cell transfusion in over 60% of their patients. The majority of cardiac surgeons employ cardiotomy suction to preserve autologous blood during on-pump coronary artery bypass surgery; however the use of cardiotomy suction is associated with a more pronounced systemic inflammatory response and a resulting coagulopathy as well as exacerbating the microembolic load. This leads to a tendency to increased blood loss, transfusion requirement and organ dysfunction. Conversely, the avoidance of cardiotomy suction in coronary artery bypass surgery is not associated with an increased transfusion requirement. There is therefore no indication for the routine use of cardiotomy suction in on-pump coronary artery surgery.

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References

1. Stover EP, Siegel LC, Parks R, Levin J, Body SC, Maddi R, D'Ambra MN, Mangano DT, Spiess BD. Variability in transfusion practice for coronary artery bypass surgery persists despite national consensus guidelines: a 24-institution study. Institutions of the Multicenter Study of Perioperative Ischemia Research Group. Anesthesiology. 1998;88:327–33. doi: 10.1097/00000542-199802000-00009. - DOI - PubMed
1. Moise SF, Higgins MJ, Colquhoun AD. A survey of blood transfusion proactice in UK cardiac surgery units. Crit Care. 2001;5:5.
1. Mercuriali F, Inghilleri G. Transfusion risks and limitations. Minerva Anestesiol. 1999;65:286–92. - PubMed
1. Kuduvalli M, Oo AY, Newall N, Grayson AD, Jackson M, Desmond MJ, Fabri BM, Rashid A. Effect of peri-operative red blood cell transfusion on 30-day and 1-year mortality following coronary artery bypass surgery. Eur J Cardiothorac Surg. 2005;27:592–8. doi: 10.1016/j.ejcts.2005.01.030. - DOI - PubMed
1. Rogers MA, Blumberg N, Saint SK, Kim C, Nallamothu BK, Langa KM. Allogeneic blood transfusions explain increased mortality in women after coronary artery bypass graft surgery. Am Heart J. 2006;152:1028–34. doi: 10.1016/j.ahj.2006.07.009. - DOI - PubMed

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[1] Stover EP, Siegel LC, Parks R, Levin J, Body SC, Maddi R, D'Ambra MN, Mangano DT, Spiess BD. Variability in transfusion practice for coronary artery bypass surgery persists despite national consensus guidelines: a 24-institution study. Institutions of the Multicenter Study of Perioperative Ischemia Research Group. Anesthesiology. 1998;88:327–33. doi: 10.1097/00000542-199802000-00009. - DOI - PubMed

[2] Stover EP, Siegel LC, Parks R, Levin J, Body SC, Maddi R, D'Ambra MN, Mangano DT, Spiess BD. Variability in transfusion practice for coronary artery bypass surgery persists despite national consensus guidelines: a 24-institution study. Institutions of the Multicenter Study of Perioperative Ischemia Research Group. Anesthesiology. 1998;88:327–33. doi: 10.1097/00000542-199802000-00009. - DOI - PubMed

[3] Moise SF, Higgins MJ, Colquhoun AD. A survey of blood transfusion proactice in UK cardiac surgery units. Crit Care. 2001;5:5.

[4] Moise SF, Higgins MJ, Colquhoun AD. A survey of blood transfusion proactice in UK cardiac surgery units. Crit Care. 2001;5:5.

[5] Mercuriali F, Inghilleri G. Transfusion risks and limitations. Minerva Anestesiol. 1999;65:286–92. - PubMed

[6] Mercuriali F, Inghilleri G. Transfusion risks and limitations. Minerva Anestesiol. 1999;65:286–92. - PubMed

[7] Kuduvalli M, Oo AY, Newall N, Grayson AD, Jackson M, Desmond MJ, Fabri BM, Rashid A. Effect of peri-operative red blood cell transfusion on 30-day and 1-year mortality following coronary artery bypass surgery. Eur J Cardiothorac Surg. 2005;27:592–8. doi: 10.1016/j.ejcts.2005.01.030. - DOI - PubMed

[8] Kuduvalli M, Oo AY, Newall N, Grayson AD, Jackson M, Desmond MJ, Fabri BM, Rashid A. Effect of peri-operative red blood cell transfusion on 30-day and 1-year mortality following coronary artery bypass surgery. Eur J Cardiothorac Surg. 2005;27:592–8. doi: 10.1016/j.ejcts.2005.01.030. - DOI - PubMed

[9] Rogers MA, Blumberg N, Saint SK, Kim C, Nallamothu BK, Langa KM. Allogeneic blood transfusions explain increased mortality in women after coronary artery bypass graft surgery. Am Heart J. 2006;152:1028–34. doi: 10.1016/j.ahj.2006.07.009. - DOI - PubMed

[10] Rogers MA, Blumberg N, Saint SK, Kim C, Nallamothu BK, Langa KM. Allogeneic blood transfusions explain increased mortality in women after coronary artery bypass graft surgery. Am Heart J. 2006;152:1028–34. doi: 10.1016/j.ahj.2006.07.009. - DOI - PubMed

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Coronary artery surgery: cardiotomy suction or cell salvage?

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Coronary artery surgery: cardiotomy suction or cell salvage?

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