title: Pericardial suction blood separation attenuates inflammatory response and hemolysis after cardiopulmonary bypass.
abstract: OBJECTIVE
  Retransfusion of pericardial suction blood (PSB) is critically considered under the aspect of the biocompatibility of the cardiopulmonary bypass (CPB). We investigated various indicators of inflammation and blood cell activation associated with CPB and re-transfusion of PSB during cardiac surgery.
  
  
  METHODS
  Thirty-five patients undergoing elective coronary artery bypass grafting were prospectively randomized into two groups. In group A (n = 15, retransfusion group) the pericardial suction blood was continuously retransfused during CPB, in group B (n = 20, no-retransfusion group) the suction blood was separated. Parameters indicating the status of the inflammation and blood cell activation were analyzed before and at the end of CPB, latest after 90 minutes on CPB.
  
  
  RESULTS
  Patients' perioperative data did not differ between groups. The inflammatory markers C-reactive protein, PMN-Elastase and Interleukin-6 increased in both groups after CPB (p < 0.04) with significantly lower values in the no-retransfusion group (p < 0.02). Leukocytes and platelet activation markers beta-Thromboglobulin and soluble P-Selectin also experienced a significant elevation during observation time (p < 0.02) without any difference between the groups. Free hemoglobin and LDH tremendously increased during CPB with lower values in the no-retransfusion group.
  
  
  CONCLUSIONS
  Cardiotomy suction is a major cause of hemolysis and contributes significantly to the systemic inflammatory response.
authors.affiliation: Department of Cardiac Surgery, University of Rostock, Schillingallee 35, 18057, Rostock, Germany.
authors.forename: Christian A
authors.initials: CA
authors.lastname: Skrabal
authors.forename: Amir
authors.initials: A
authors.lastname: Khosravi
authors.forename: Yeong H
authors.initials: YH
authors.lastname: Choi
authors.forename: Alexander
authors.initials: A
authors.lastname: Kaminski
authors.forename: Bernd
authors.initials: B
authors.lastname: Westphal
authors.forename: Gustav
authors.initials: G
authors.lastname: Steinhoff
authors.forename: Andreas
authors.initials: A
authors.lastname: Liebold
mesh_terms: D015415:Biomarkers / Q000097:blood*; D001777:Blood Coagulation; D001804:Blood Transfusion, Autologous / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000379:methods*; D001026:Coronary Artery Bypass; D016207:Cytokines / Q000378:metabolism; D006461:Hemolysis; D006801:Humans; D007958:Leukocyte Count; D015539:Platelet Activation; D010976:Platelet Count; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D013396:Suction; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology* / Q000517:prevention & control*
chemical_list: D015415:Biomarkers; D016207:Cytokines