![]() Surgical trauma from opening the chest results in substantial tissue damage and release of tissue factor. On the other hand, it has been shown to increase the burden of microembolisation and potentiates the systemic inflammatory response.īlood which has extravasated into the pericardial or pleural cavities and which is subsequently aspirated by cardiotomy suction differs markedly from intravascular blood or blood within a closed CPB circuit. ![]() Recent evidence however, suggests that the return of shed blood by cardiotomy suction does not reduce blood loss or blood transfusion requirement in CABG. The aim was to reduce blood loss and hence the need for allogeneic blood transfusions with its known risk of mortality, other sequelae and cost. The cardiotomy suction apparatus was introduced in the 1960s as an extension of the intracardiac vent to allow blood shed into the operative field to be returned to the cardiopulmonary bypass (CPB) circuit. ![]() However there remains significant associated morbidity, including bleeding and secondary organ dysfunction such as neurological and renal impairment. The results of on-pump coronary artery bypass surgery are excellent in terms of early mortality. 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.
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