Coronary artery surgery: cardiotomy suction or cell salvage?

Lau, Kean‐Wah; Shah, H.; Kelleher, Andrea; Moat, Neil

doi:10.1186/1749-8090-2-46

Cited by 26 publications

(29 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Conversely, the cardiotomy suction component of a CPB system is the major source of hemolysis because of the amount of air that is aspirated together with the blood [79]. Beside the intensity of mechanical shear stress, RBCs can also have different susceptibilities to this stress, such as pediatric RBCs or RBCs exposed to hypothermia or hemodilution solutions which do not have plasma proteins.…”

Section: Optimizing Cardiac Surgical Procedures and Cpb Parametersmentioning

confidence: 99%

“…During blood processing, only RBCs are retained while the plasma, platelets, heparin, plasma-free hemoglobin (PfHb), and inflammatory mediators are discarded with the wash solution. The resulting RBCs are finally suspended at a hematocrit of 50-70% in normal saline and reinfused [79]. As of now, there are no data regarding the impact of such blood-sparing techniques on renal outcomes.…”

Section: Optimizing Cardiac Surgical Procedures and Cpb Parametersmentioning

confidence: 99%

“…Possible strategies to reduce hemolysis and its clinical consequences include: application of a separate cardiotomy reservoir to eliminate damaged RBCs and PfHb [79], administration of haptoglobin or NO donors such as sodium nitroprusside compensating for the decrease of endogenous NO caused by the binding with PfHb [83], and usage of super high-flux 100,000-Da hemofilter to remove PfHb as efficiently as washing and centrifugation [86]. …”

Section: Optimizing Cardiac Surgical Procedures and Cpb Parametersmentioning

confidence: 99%

See 2 more Smart Citations

Cardiac Surgery-Associated Acute Kidney Injury

et al. 2014

View full text Add to dashboard Cite

Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common and serious postoperative complication of cardiac surgery requiring cardiopulmonary bypass (CPB), and it is the second most common cause of AKI in the intensive care unit. Although the complication has been associated with the use of CPB, the etiology is likely multifactorial and related to intraoperative and early postoperative management including pharmacologic therapy. To date, very little evidence from randomized trials supporting specific interventions to protect from or prevent AKI in broad cardiac surgery populations has been found. The definition of AKI employed by investigators influences not only the incidence of CSA-AKI, but also the identification of risk variables. The advent of novel biomarkers of kidney injury has the potential to facilitate the subclinical diagnosis of CSA-AKI, the assessment of its severity and prognosis, and the early institution of interventions to prevent or reduce kidney damage. Further studies are needed to determine how to optimize cardiac surgical procedures, CPB parameters, and intraoperative and early postoperative blood pressure and renal blood flow to reduce the risk of CSA-AKI. No pharmacologic strategy has demonstrated clear efficacy in the prevention of CSA-AKI; however, some agents, such as the natriuretic peptide nesiritide and the dopamine agonist fenoldopam, have shown promising results in renoprotection. It remains unclear whether CSA-AKI patients can benefit from the early institution of such pharmacologic agents or the early initiation of renal replacement therapy.

show abstract

Section: Optimizing Cardiac Surgical Procedures and Cpb Parametersmentioning

confidence: 99%

Section: Optimizing Cardiac Surgical Procedures and Cpb Parametersmentioning

confidence: 99%

Section: Optimizing Cardiac Surgical Procedures and Cpb Parametersmentioning

confidence: 99%

See 1 more Smart Citation

Cardiac Surgery-Associated Acute Kidney Injury

et al. 2014

View full text Add to dashboard Cite

show abstract

“…It has been well-demonstrated that the use of plain cardiotomy suction without ultrafiltration is associated with a more pronounced systemic inflammatory response and a resulting coagulopathy and an increased microembolic load. 27 More commonly in today's practice, the cardiotomy suction and entire venous reservoir undergo hemoconcentration and ultrafiltration. This leads to decreased extravascular fluids with a higher hematocrit and removal of inflammatory mediators.…”

Section: Commentary 1 IImentioning

confidence: 99%

“…28 Similarly, cell salvage can reduce the concentration of inflammatory mediators by 90% to 95% and decrease the fat microembolic load by as much as 85%. 27,29 Unfortunately, cell salvage "washes out" the plasma and platelets. In a Jehovah's Witnesses patient, the decision to preserve plasma and platelets becomes very important and the use of the cardiotomy suction with appropriate hemoconcentration and ultrafiltration may be more beneficial.…”

Section: Commentary 1 IImentioning

confidence: 99%

Successful Ascending Aorta and Hemiarch Replacement and Aortic Valve Resuspension Via Redo Median Sternotomy Using Hypothermic Circulatory Arrest in a Practicing Jehovah's Witnesses Patient

Gamble

Maxwell

Gaca

et al. 2019

Journal of Cardiothoracic and Vascular Anesthesia

View full text Add to dashboard Cite

Electrochemical generation of nitric oxide for medical applications

White

Lehnert

Meyerhoff

2021

Electrochemical Science Adv

View full text Add to dashboard Cite

Over the past 30 years, the significance of nitric oxide (NO) has become increasingly apparent in mammalian physiology. It is biosynthesized by three isoforms of nitric oxide synthases (NOS): neuronal (nNOS), endothelial (eNOS), and inducible (iNOS). nNOS and eNOS both produce low levels of NO (nM) as a signaling agent and vasodilator, respectively. iNOS is present in activated macrophages at sites of infection to generate acutely toxic (μM) levels of NO as part of the mammalian immune defense mechanism. These discoveries have led to numerous animal and clinical studies to evaluate the potential therapeutic utility of NO in various medical operations/treatments, primarily using NO gas (via gas-cylinders) as the NO source. In this review, we focus specifically on recent advances in the electrochemical generation of NO (E-NOgen) as an alternative means to generate NO from cheap and inert sources, and the fabrication and testing of biomedical devices that utilize E-NOgen to controllably generate NO for medical applications.

show abstract

Coronary artery surgery: cardiotomy suction or cell salvage?

Cited by 26 publications

References 42 publications

Cardiac Surgery-Associated Acute Kidney Injury

Cardiac Surgery-Associated Acute Kidney Injury

Successful Ascending Aorta and Hemiarch Replacement and Aortic Valve Resuspension Via Redo Median Sternotomy Using Hypothermic Circulatory Arrest in a Practicing Jehovah's Witnesses Patient

Electrochemical generation of nitric oxide for medical applications

Contact Info

Product

Resources

About