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

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Objective: Elimination of cardiotomy suction increases reliance on cell-saver blood-conservation techniques. Reinfusion of processed cell-saver blood (PCSB) even without using cardiotomy field suction may contribute to thrombin, cytokines, platelet activators, and hemolytic factors measured systemically. Design: This study was designed as a prospective, un-blinded observational study of patients undergoing first time, non-emergent on-pump coronary artery bypass graft surgery. Setting: A university medical center. Participants: Fourteen patients were enrolled after informed consent. Interventions: Arterial blood was sampled (1) before cardiopulmonary bypass, (2) immediately after bypass, and (3) 4 hours after bypass. PCSB, using the AutoLog (Medtronic, Inc, Minneapolis, MN), was sampled after bypass. Measurements and Main Results: Blood and PCSB levels of prothrombin fragments 1.2, -thromboglobulin, interleukin- 6, interleukin-8, polymorphonuclear leukocyte-elastase, neuron-specific enolase, and S-100 were assayed by using enzyme-linked immunosorbent assay. Paired comparisons were performed by using paired t tests. Compared with post-bypass blood, processed cell-saver blood (prepatient infusion) had higher levels of polymorphonuclear leukocytelastase, interleukin-8, neuron-specific enolase, and S-100 (p < 0.05). Conclusions: Reinfusion of PCSB directly and independently contributes to systemic elevations in interleukin-8, polymorphonuclear elastase, neuronspecific enolase, and S-100B, augmenting and perhaps accentuating the postoperative inflammatory response. Further evaluation and improvement in cell-salvaging technology and processing techniques are warranted.
Munir Boodhwani, Howard J. Nathan, Fraser D. Rubens On behalf of the Cardiotomy Investigators Scientific Sessions 2006 Chicago, Illinois November 13, 2006 The authors have no conflicts of interest to disclose
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
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Page 16 and 17: • -Proinflammatory mediators •
Page 18: Should we discard cardiotomy suctio
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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: Abstract Objective: During cardiopu
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

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