Pericardial suction blood separation attenuates inflammatory response and hemolysis after cardiopulmonary bypass.
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.
Skrabal
Christian A
CA
Department of Cardiac Surgery, University of Rostock, Schillingallee 35, 18057, Rostock, Germany.
Khosravi
Amir
A
Choi
Yeong H
YH
Kaminski
Alexander
A
Westphal
Bernd
B
Steinhoff
Gustav
G
Liebold
Andreas
A
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*
D015415:Biomarkers; D016207:Cytokines