Comparison of Blood Activation in the Wound, Active Vent, and Cardiopulmonary Bypass Circuit

Fabre, Olivier; Vincentelli, André; Corseaux, Delphine; Juthier, Françis; Susen, Sophie; Bauters, Anne; Belle, Éric Van; Mouquet, Frédéric; Tourneau, Thierry Le; Decoene, Christophe; Crépin, F.; Prat, Alain; Jude, Brigitte

doi:10.1016/j.athoracsur.2008.02.076

Cited by 23 publications

(10 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Surgical trauma increases microvesicle production in cardiac surgery in addition to the effect of CPB, since pericardial blood contains higher concentrations of coagulation markers and microvesicles than blood in the left ventricle. 64,65,76 …”

Section: Surgical Traumamentioning

confidence: 99%

Platelet Microvesicles (Microparticles) in Cardiac Surgery

Tempo

Englyst

Holloway

et al. 2016

Journal of Cardiothoracic and Vascular Anesthesia

View full text Add to dashboard Cite

Section: Surgical Traumamentioning

confidence: 99%

Platelet Microvesicles (Microparticles) in Cardiac Surgery

Tempo

Englyst

Holloway

et al. 2016

Journal of Cardiothoracic and Vascular Anesthesia

View full text Add to dashboard Cite

“…32 Other investigators suggest that negative blood pressures are of minor importance to hemolysis compared with other factors during CPB. 33 Yet, it seems reasonable, as far as possible, to avoid exposing the blood to excessive negative pressures during pulsatile flow. To that end, we optimized the CPB pulse settings to maximize the pulse amplitude within acceptable negative pressure limits.…”

Section: Discussionmentioning

confidence: 99%

Cerebral oxygen saturation during pulsatile and non-pulsatile cardiopulmonary bypass in patients with carotid stenosis

2015

View full text Add to dashboard Cite

Pulsatile and non-pulsatile cardiopulmonary bypass (CPB) flows may have different impact on cerebral oxygen saturation in patients with restricted cerebral arterial blood supply. Twenty patients, ten diagnosed with carotid stenosis (CS, n = 10) and ten without known carotid disease (Controls, n = 10), were subjected to one period of pulsatile and one period of non-pulsatile flow (6-8 min each) during CPB at 32°C. Cerebral oxygen saturation was registered by near-infrared light spectroscopy (NIRS).The mean arterial pressure (MAP) was significantly lowered by pulsatile CPB flow. The NIRS tissue oxygenation index (TOI) tended to decrease in the CS group and increase in the Controls during pulsatile flow compared with non-pulsatile; however, the changes were not statistically significant.No significant correlations were seen between the changes in MAP and TOI across the observation periods.In conclusion, pulsatile CPB flow caused slightly decreased mean arterial pressure while the effect on cerebral oxygenation was unclear. Pulsatile flow was not found superior to non-pulsatile flow in patients with or without carotid stenosis.

show abstract

“…It is somewhat counterintuitive that one might see less overall drainage when chest tube patency is improved. However, it is well described that the tissue plasminogen activator content of shed mediastinal blood is high [24]. Tissue plasminogen activator results in fibrinolysis and microvascular bleeding.…”

Section: Original Articlementioning

confidence: 99%

Active clearance of chest tubes after cardiac surgery: a propensity score matched analysis

et al. 2020

View full text Add to dashboard Cite

AIMS OF THE STUDY: Chest tubes inserted to drain shed mediastinal blood after cardiac surgery often become clogged, limiting their capacity to evacuate blood, and leading to blood retention and retained blood syndrome. The aim of this study was the assessment of the efficacy of an active tube clearance (ATC) system in the reduction of retained blood syndrome after cardiac surgery.METHODS: This study included 2461 adult patients undergoing major cardiac surgery. Patients receiving conventional chest tubes only (n = 1980) were compared with patients receiving an ATC tube in the retrosternal position (n = 481) for interventions caused by retained blood syndrome (re-exploration for bleeding or tamponade and interventions for pleural effusion or pneumothorax), kidney replacement therapy, postoperative atrial fibrillation, sternal infection and chest tube output before and after propensity score matching. RESULTS: Propensity score matching generated 471 patient-pairs balanced for their baseline characteristics. Matched patients with an ATC tube in the retrosternal position had no statistically significant difference in the rate of intervention for retained blood syndrome (33% vs 31%, p = 1), re-exploration because of bleeding or tamponade (2.5% vs 4%, p = 1), intervention for pneumothorax (4.7% vs 4.9%, p = 1) and intervention for pleural effusion (28% vs 28%, p = 1), but had statistically significantly less chest tube output on the first postoperative day (median 480, IQR 316-700 ml vs median 590, IQR 380-905 ml; p <0.0001) and second postoperative day (median 505, IQR 342-800 ml vs median 597, IQR 383-962 ml; p = 0.0012) in comparison with patients with conventional chest tubes only.CONCLUSION: An ATC tube in the retrosternal position reduced chest tube output but showed no reduction in the rate of intervention for retained blood syndrome. Further research should be performed to test the combination of ATC in the retrosternal and the inferior pericardial space.

show abstract

Comparison of Blood Activation in the Wound, Active Vent, and Cardiopulmonary Bypass Circuit

Cited by 23 publications

References 32 publications

Platelet Microvesicles (Microparticles) in Cardiac Surgery

Platelet Microvesicles (Microparticles) in Cardiac Surgery

Cerebral oxygen saturation during pulsatile and non-pulsatile cardiopulmonary bypass in patients with carotid stenosis

Active clearance of chest tubes after cardiac surgery: a propensity score matched analysis

Contact Info

Product

Resources

About