SABM James D. Ferguson, Keith A. Samolyk, Victor Carcioppolo ...

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Cardiotomy Blood Concerns -Significant literature suggests that the use of shed blood returned directly to the cardiotomy should only be used when extremely necessary. (Journal of Cardiothoracic and Vascular Anesthesia 2004;21: 519-523) -The increased concentrations of thrombin-antithrombin III complex and fibrin degradation products indicated renewed systemic clotting and fibrinolysis as a direct result of the retransfusion of suctioned blood. (Ann Thorac Surg 1996;62:717-23) -“The retransfusion of highly activated suctioned blood during CPB exacerbates wound bleeding.” (Ann Thorac Surg 1995; 59: 901-07) -Furthermore, coronary surgery without retransfusion of cardiotomy suction blood and mediastinal shed blood reduces the postoperative systemic inflammatory response. (Journal of Cardiothorac and Vasc Anesth 2004;21: 519- 523)
More Cardiotomy Blood Concerns • “Recent studies have focused on the origins of thrombotic stimulus and the possible role of retransfused suctioned blood from the thoracic cavities on the activation of the extrinsic coagulation pathway.” • 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. – Use of a cell washer to scavenge shed blood during CPB decreases cerebral lipid microembolization. Ann of Thorac Surg 2000;70: 1296-1300
Page 1 and 2: SABM James D. Ferguson, Keith A. Sa
Page 3: • It’s time for Perfusion and t
Page 8 and 9: Mortality & Morbidity TRALI (Tx Re
Page 10: • Are there components found in s
Page 16 and 17: • -Proinflammatory mediators •
Page 18: Should we discard cardiotomy suctio
Page 23 and 24: “The risk of stroke postoperative
Page 25: • Dr Stump’s s research on card
Page 28 and 29: Approved by the Wake Forest Univers
Page 30: Number of Cerebral Lipid Microembol
Page 33 and 34: • A national survey conducted Jus
Page 35 and 36: • Methods - 71 patients were enro
Page 37 and 38: The study showed Shed Mediastinal B
Page 39 and 40: The Meta-Analysis contained 31 rand
Page 41 and 42: Abstract Objective: During cardiopu
Page 43 and 44: Munir Boodhwani, Howard J. Nathan,
Page 45 and 46: Conclusions from Study Contrary to
Page 47 and 48: So what can we determine from all o
Page 49 and 50: Abstract: Cell salvage devices are
Page 51 and 52: Autotransfusion Pitfalls The potent
Page 53 and 54: Remove 70-90% of soluble contaminan
Page 55 and 56: Quality improves by process change:
Page 57 and 58: We are at a conundrum in cardiac su
Page 59 and 60: 1. Belway, D., Rubens, F., Wonzy, D
Page 61: 13. Shann, K. G., Likosky, D. S., M

SABM James D. Ferguson, Keith A. Samolyk, Victor Carcioppolo ...

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