INTRAOPERATIVE BLOOD SALVAGE TECHNIQUES

Cardiac surgical procedures are a major source of the total amount of blood used for transfusion purposes in the United States The propensity for major blood loss during open heart surgical procedures is due to a combination of the extensive intervention involving major vascular structures and the inherent derangement of hemostasis that accompanies the use of extracorporeal circulatory techniques.
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heart lung machine

Cardiopulmonary bypass ( CPB ) is a technique that temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and the oxygen content of the patient's body. The CPB pump itself is often referred to as a heart–lung machine or "the pump". Cardiopulmonary bypass pumps are operated by perfusionists. CPB is a form of extracorporeal circulation. Extracorporeal membrane oxygenation is generally used for longer-term treatment.

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cardiopulmonary bypass and cardioplegia

Extracorporeal circulation and cardiopulmonary bypass are synonymous terms denoting a method by which the blood that usually returns directly to the heart is temporarily drained from the superior and inferior venae cavae. The blood is diverted into a reservoir, where it is oxygenated and subsequently returned to the patient’s arterial circulation. This process effectually excludes the heart from the general circulation and leaves it empty so that it can accommodate surgical intervention. Myocardial protection To provide a dry, motionless, operative area, a cross-clamp is placed across the ascending aorta above the coronary ostia and proximal to the aortic cannula, thus isolating the coronary circulation and preventing blood entering the chambers of the heart. Therefore, techniques of myocardial protection are used to preserve myocardial function and prevent cell death. Cardioplegic techniques for myocardial protection involve the delivery of cardioplegic solution t...

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