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Cardiotomy suction during on-pump surgery amplifies systemic inflammation, coagulopathy, microemboli, and hemolysis.
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Cardiotomy suction is used for preservation of autologous blood during on-pump cardiac surgery at present. Controversially, the exclusion of cardiotomy suction in some types of operations (coronary artery bypass surgery) is not necessarily associated with an increased transfusion requirement. On the other hand, the use of cardiotomy suction causes an amplification of systemic inflammatory response and a resulting coagulopathy, as well as exacerbation of the microembolic load and hemolysis. This leads to a tendency towards increased blood loss, transfusion requirement and organ dysfunction. On the basis of these facts, it is appropriate to reconsider routine use of cardiotomy suction in on-pump coronary artery surgery.
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Svitek et al. (2010) conducted a review in On-pump cardiac surgery / coronary artery bypass surgery. Cardiotomy suction vs. Exclusion of cardiotomy suction was evaluated. Cardiotomy suction during on-pump cardiac surgery amplifies systemic inflammation, coagulopathy, microembolic load, and hemolysis, warranting reconsideration of its routine use in CABG.
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