Dealing with pericardial suction blood and residual pump volume: a review of current practices in the UK.
The pathological effects of pericardial suction blood (PSB) have been well described in numerous studies for many years; yet, despite this, there is no definitive answer to the question of how best to attenuate this pathology. More recently, large studies have shown that, whilst PSB contains many factors indicating its pathological potential, the direct re-infusion of PSB and residual pump volume (RPV) after cardiopulmonary bypass (CPB) potentially reduces the risk of transfusion and is no more harmful to the patient than the re-infusion of cell salvage-processed PSB after CPB.We conducted a telephone audit of UK perfusion units to determine if current protocols and practices reflected this.We found that there is a definite majority processing RPV with cell-saving devices, with many units defining their protocols as "surgeon dependent" whilst half immediately returned PSB to the systemic circulation whilst on CPB. The results of this national audit suggest that the issue of dealing with PSB and RPV is confused, heavily influenced by surgical and anaesthetic preference and lacking clear guidance and high quality evidence.
Issitt
Richard
R
Perfusion Department, John Radcliffe Hospital, Oxford, UK. richard.issitt@orh.nhs.uk
Sheppard
Stuart
S
D001781:Blood Component Removal; D001804:Blood Transfusion, Autologous; D002315:Cardiopulmonary Bypass; D006801:Humans; D015918:Infusion Pumps, Implantable; D008485:Medical Audit; D010496:Pericardium; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013396:Suction / Q000295:instrumentation*