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At least 217 records · Page 12Linked to original sources
PubMed1999

Are endoscopic biopsies of small bowel as good as suction biopsies for diagnosis of enteropathy?

BACKGROUND: Endoscopy is increasingly used in paediatric practice for diagnosis of enteropathy, although the quality of grasp forceps-obtained biopsy specimens required for reliable diagnosis has been questioned in comparison with suction capsule biopsy specimens. This study prospectively compared the diagnostic suitability of grasp forceps biopsy versus suction biopsy in the same patient during the same procedure. METHODS: A double-port paediatric suction biopsy capsule was front-loaded onto an endoscope and directed to the fourth part duodenum-proximal jejunum for biopsy sampling. Subsequently, three grasp biopsy specimens were taken from the same region. All biopsies were coded, photographed, and measured for area, using computed morphometry. A single blinded histopathologist assessed sample adequacy for diagnosis. Twenty-nine patients were enrolled (age range, 8-185 months). RESULTS: On three occasions the suction capsule failed to fire, and on four occasions only one sample was obtained. Three grasp biopsy specimens were obtained on each occasion by endoscopy, and the first two were used for comparison with suction biopsy samples. Median total area of individual biopsy samples obtained by the two procedures was not different (21.3 vs. 22.5 mm2; P = 0.027). Muscularis mucosae was obtained more commonly with grasp biopsies (P<0.001), and no difference was observed for the presence of three or more villus-crypt units, degree of haemorrhage, or optimal orientation. Two suction biopsy procedures and one grasp biopsy procedure were inadequate for diagnosis. CONCLUSIONS: Endoscopic grasp biopsies are perfectly adequate for the assessment of small intestinal histology. In addition, endoscopy affords advantage in diagnosis of other upper gastrointestinal disease with avoidance of radiologic screening involved with the suction capsule technique.

Adolescent↗
PubMed2003

Submental suction-assisted lipectomy without platysmaplasty: pushing the (skin) envelope to avoid a face lift for unsuitable candidates.

Patients with submental fullness may not be candidates for a full or short-scar face lift because of medical contraindications, uncontrolled hypertension, a refractory nicotine habit, or anticoagulant medications, or patients may disqualify themselves because of cost, unavailable recovery time, or emotional resistance. Submental suction-assisted lipectomy has traditionally been reserved for younger patients. For older patients, suction-assisted lipectomy is typically used as an adjunct for face/neck lifts. This report describes experiences with suction-assisted lipectomy for older patients who were not face lift candidates, for the aforementioned reasons. The study goals were to better delineate the indications for submental suction-assisted lipectomy, as opposed to a face lift, and to obtain improved results with a less-invasive procedure. A 6-year study involving 132 patients (21 to 73 years of age), of whom 4.5 percent were men, was performed. Eighty-eight patients (67 percent), the primary focus of this study, were more than 40 years of age. Of those 88 patients, 24 patients (18 percent of the 132 patients in this series) were in their forties, 45 (34 percent) were in their fifties, 16 (12 percent) were in their sixties, and three (2.3 percent) were at least 70 years of age. The median follow-up time in this series was more than 1 year. The results were assessed with the five criteria for facial rejuvenation described by Ellenbogen and Karlin. All patients demonstrated improvement, with three to five of the Ellenbogen-Karlin neck rejuvenation criteria being met for each patient. All patients demonstrated an improved submandibular border, a more visible anterior sternocleidomastoid muscle border, and an improved neck angle (as determined with angle measurements). For many patients, all five of the Ellenbogen-Karlin criteria were met. A visible subhyoid depression and a visible thyroid cartilage bulge were the two criteria most often not met. A retrospective evaluation using Baker's preoperative classification of patient types for short-scar face lifts was performed. Results for patients more than 64 years of age (11 patients) were less satisfactory, often with redundant or crepe paper-like skin. Submental suction-assisted lipectomy, as opposed to a face lift, was observed to be a reasonable alternative for older patients who were unable or unwilling to undergo a face lift. Localized fullness in the midline was observed to be the best predictor of a good outcome (even better than age or skin tone). A crepe paper appearance of the skin preoperatively was the best predictor of failure. The surgical anatomical features, technique, advantages, disadvantages, and principles are discussed. Complications and their treatment are addressed. It is concluded that submental suction-assisted lipectomy alone, without platysmaplasty, can be helpful for patients with submental fullness who are unsuitable candidates for a face lift and who accept the limitations of liposuction without platysmaplasty. Suction-assisted lipectomy can sufficiently contract and smooth the skin envelope for selected patients, with less consideration for age than previously proposed.

Adult↗
PubMed2004

Measurement of cytokine expression and Langerhans cell migration in human skin following suction blister formation.

Contact allergen-induced migration of epidermal Langerhans cells (LCs) to draining lymph nodes is dependent upon receipt by LCs of at least two cytokine signals provided by tumor necrosis factor-alpha (TNF-alpha) and interleukin (IL)-1beta. It has been reported previously that intradermal injection of healthy human volunteers with homologous TNF-alpha or IL-1beta each induces a significant reduction in LC frequency, as measured in epidermal sheets prepared from 6-mm punch biopsies. In the current experiments, we have compared the frequency of LCs in punch biopsies with those obtained concurrently in epidermal sheets from the roofs of suction blisters isolated from the sun-protected buttock skin of healthy adult volunteers. There was a significant, approximately 30%, reduction in CD1a(+) LC numbers in suction blister roofs compared with punch biopsies. Injection of homologous recombinant IL-1beta, a stimulus that provokes measurable epidermal LC mobilization in punch biopsy sites, failed to provoke further LC migration in suction blister sites. These data suggest that the mechanical trauma to the skin caused by the creation of suction blisters provokes the degree of cutaneous inflammation necessary for LC mobilization. The responsive cells (only a proportion of resident LCs, approximately 30%) have already migrated, thus addition of an exogenous cytokine signal (IL-1beta) is without further effect. It is not possible therefore to measure the regulation of LC mobilization by exogenous cytokines in suction blister roofs. However, this technique provides an opportunity to profile induced changes in the cutaneous cytokine environment, with cytokine expression measured by a multiple cytokine array system. Using this technique, intradermal injection of IL-1beta was found to cause a marked upregulation of proinflammatory cytokines including TNF-alpha, IL-6, IL-8, monocyte chemotactic protein-1 (MCP-1) and the anti-inflammatory cytokine IL-10 in fluid from suction blisters raised at the site of injection. In conclusion, the suction blister technique appears to be a powerful tool for measurement of induced changes in cutaneous cytokines.

Adult↗
PubMed1986

Ventricular suction under zero source pressure for filling.

We quantified ventricular suction flow, volume, and pressure under hydrostatically zero source pressure for filling. A large-bore electromagnetic flow probe was placed in the valve-free mitral annulus of the dog heart that had been excised and was cross circulated with the left atrium widely opened. With the heart immersed in a blood pool, ventricular suction flow and transmural pressure were measured. After a rapid ejection flow [peak: 110 +/- 47 (SD) ml . s-1 . 100 g left ventricle-1] during systole, a slow suction flow (peak: 26 +/- 20 ml . s-1 . 100 g-1) occurred during diastole despite the zero source pressure for filling. Peak transmural pressure during ejection was 6 +/- 3 mmHg, and peak negative transmural pressure during suction was 2 +/- 1 mmHg. Suction volume, which was equal to ejection volume in steady state, was 8 +/- 3 ml/100 g left ventricle. Increases in paced heart rate markedly decreased suction volume by curtailing diastolic filling time. Epinephrine, propranolol, calcium, and verapamil variably changed suction volume, and these effects were primarily accounted for by the accompanied heart rate changes.

Analysis of Variance↗
PubMed2006

Sorption of trace metals by standard and micro suction cups in the absence and presence of dissolved organic carbon.

Both the bioavailability of a trace metal (TM) in a soil and the risk of leaching to the ground water are linked to the metals concentration in the soil solution. Sampling soil solution by tension lysimetry with suction cups is a simple and established technique that is increasingly used for monitoring dissolved TM in soils. Of major concern, however, is the sorption of TM by the walls of the samplers. Metal sorption by different materials used in suction cups can vary widely, depending also on the chemistry of the soil solution. We compared the sorption of Cu, Zn, Cd, and Pb by different standard-size and micro suction cups in the laboratory at two pH values (4.5 and 7.5 or 8.0) in absence and presence of dissolved organic carbon (DOC). In addition, we investigated the sorption of DOC from different origins by the cup materials. At both pH values, the weakest sorption of all four TMs was exhibited by standard-size suction cups based on nylon membranes and by hollow fibers made from polyvinyl alcohol (PVA). At alkaline pH, borosilicate glass, ceramic materials, and polytetrafluorethylene (PTFE) mixed with silicate were characterized by generally strong sorption of all investigated TMs. In addition, Cu and Pb were strongly sorbed at low pH by PTFE-silicate and a ceramic material used for the construction of standard-size suction cups. On the other hand, sorption of Cu, Zn, and Cd by ceramic capillaries produced from pure aluminum oxide was negligible at low pH. Micro suction cups made of an unknown polymerous tube sorbed Cu strongly, but were well suited to monitor Zn, Cd, and Pb at low pH, and, in the presence of DOC, also at high pH. Major cations (Na+, Mg2+, K+, Ca2+) and anions (Cl-, NO3-, SO4(2-)) were not or very weakly sorbed by all cup materials, except for Mg2+, K+, and Ca2+ by borosilicate glass at pH 7.5. Trace metal sorption by suction cups was generally greatly reduced in the presence of DOC, especially at alkaline pH. The sorption of DOC itself depended on its source. Dissolved organic carbon from leaf litter extracts with a probably large hydrophobic fraction was sorbed more strongly than mainly hydrophilic DOC from a mineral soil solution.

Carbon↗
PubMedDate not supplied

[Do newborn infants feel pain when submitted to gastric suctioning?]

OBJECTIVES: Evaluate physiological and behavioral parameters to verify if newborns feel pain when submitted to gastric suctioning. METHODS: 50 healthy newborns over 33 weeks gestational age, weighing more than 1999g, were submitted to gastric suctioning, randomly selected, and divided into two groups: Friction/Lancing and Lancing/Friction. The newborns were assessed through the Neonatal Infant Pain Scale (NIPS) (0-7, pain>3) by two independent observers in three different moments: one minute before, during, and one minute after gastric suctioning, heel lancing and foot friction, with simultaneous monitoring of heart rate, respiratory frequency, and hemoglobin oxygen saturation. RESULTS: The respiratory frequency only decreased during gastric suctioning (P=0.004). The heart rate was lower during gastric suctioning (P<0.0001), during the heel lacing procedure in the Friction/Lancing group (P=0.01), and during friction in the Friction/Lancing group (P=0.022). The hemoglobin oxygen saturation suffered no alterations during the three procedures. The results obtained through NIPS revealed that both groups felt pain during gastric suctioning and heel lancing, and did not feel pain during friction (P<0.0001). CONCLUSION: During the gastric suctioning procedure, newborns responded as if it were a painful stimulus. Physiological alterations were neither specific nor sensitive to pain assessment in newborn infants.

Journal Article↗
PubMedDate not supplied

Suction lipectomy preceding pregnancy and postpartum results.

A retrospective case-control study was undertaken to determine if women who have undergone suction lipectomy of the abdomen, flanks and lower extremities suffer any reversal of the beneficial results of the procedure as a result of a subsequent term pregnancy and parturition. Cases with two women subjects who became pregnant and experienced full-term pregnancies and healthy childbirth shortly following suction lipectomy of the torso and lower extremities are reviewed. Bodily measurements about significant planes were recorded prior to suction lipectomy, between suction lipectomy and pregnancy, and 32 weeks postpartum. Controls included three women patients who did not become pregnant following the surgery, for whom similar measurements were available pre-suction lipectomy and post-suction lipectomy at short-term and long-term follow-up. The hiatus between follow-ups allowed for a potential gestational period to match the two cases. Results showed insignificant, if any, change between measurements before and after pregnancy in cases; in controls, excellent agreement was also achieved between measurements taken post-surgically at short-term and at long-term follow-up. Assuming normal gravid weight gain and maintenance of proper diet following pregnancy, measurements achieved by suction lipectomy are unaffected by pregnancy and parturition.

Adipose Tissue↗
PubMed1988

[The suction signal detected by color Doppler echocardiography in patients with mitral regurgitation: its clinical significance].

The present study clarified the clinical significance of the suction signal--regurgitant signal near the mitral valve in the left ventricle--as obtained by two-dimensional color Doppler echocardiography in patients with mitral regurgitation. The study population consisted of 39 patients with various heart diseases having mitral regurgitation. The presence of a mitral regurgitant signal was determined not only in the left atrium but in the left ventricle using the long-axis view, four-chamber view, and short-axis view. 1. The suction signal was observed in 17 cases; on the posteromedial commissure side in four; the central portion in seven; the anterolateral commissure side in five and the mitral aneurysm portion in one. The site of the suction signal indicated the mitral regurgitant orifice and was useful for identifying the regurgitant orifice particularly in cases with prolapse of the commissural scallop. 2. Left ventriculography was performed in 18 cases and the severity of mitral regurgitation was grade III/IV or IV/IV in seven of eight cases with suction signals and was grade II/IV in the remaining one, while it was grade II/IV or I/IV in all ten cases without the signal. Sensitivity was then 100% and specificity was 91% in diagnosing III/IV or greater regurgitation according to the presence of the suction signal. The left atrial jet distance, width and area in the 17 cases with suction signals were significantly greater than those of 22 cases without the signal (3.3 +/- 1.0 vs 1.9 +/- 0.7 cm, 1.4 +/- 0.7 vs 0.8 +/- 0.4 cm, and 4.2 +/- 2.8 vs 1.3 +/- 1.3 cm2, respectively). Thus, the suction signal in the left ventricle in mitral regurgitation provided useful information concerning not only the identification of a regurgitant orifice, but the grade of mitral regurgitation, as well.

Adult↗
PubMed1990

New microsurgical suction tubes.

A set of new suitable microsurgical suction tubes has been designed especially suitable for fragile and delicate tissues such as the nervous and vascular tissues in the brain and spinal cord. The set provides two different shafts and five different tubes for superficial of deep micro- as well as macro-operations. These new suction tubes have two major advantages compared to traditional suction tubes. Firstly: the perforated smooth suction-tip allows continuous suction without damage to the tissue and secondly: the tubes are quickly and easily exchanged from the suction shaft when necessary.

Equipment Design↗
PubMed2003

Airway colonisation in long-term mechanically ventilated patients. Effect of semi-recumbent position and continuous subglottic suctioning.

OBJECTIVE: To evaluate the impact of continuous subglottic suctioning and semi-recumbent body position on bacterial colonisation of the lower respiratory tract. DESIGN: A randomised controlled trial. SETTING: The ten-bed medical ICU of a French university hospital. PATIENTS: Critically ill patients expected to require mechanical ventilation for more than 5 days. INTERVENTIONS: Patients were randomly assigned to receive either continuous suctioning of subglottic secretions and semi-recumbent body position or to receive standard care and supine position. MEASUREMENTS AND RESULTS: Oropharyngeal and tracheal secretions were sampled daily and quantitatively cultured. All included patients were followed up from day 1 (intubation) to day 10, extubation or death. Ninety-seven samples of oropharynx and trachea were analysed (40 for the suctioning group and 57 for the control group). The median bacterial counts in trachea were 6.6 Log10 CFU/ml (interquartile range, IQR, 4.4-8.3) in patients who received continuous suctioning and 5.1 Log10 CFU/ml (IQR 3.6-5.5) in control patients. Most of the patients were colonised in the trachea after 1 day of mechanical ventilation (75% in the suctioning group, 80% in the control group). No significant difference was found in the daily bacterial counts in the oropharynx and in the trachea between the two groups of patients. CONCLUSION: Tracheal colonisation in long-term mechanically ventilated ICU patients was not modified by the use of continuous subglottic suctioning and semi-recumbent body position.

Aged↗
PubMed2004

Effectiveness and side effects of closed and open suctioning: an experimental evaluation.

OBJECTIVE: To compare the effectiveness of closed system suctioning (CSS) and open system suctioning (OSS) and the side effects on gas exchange and haemodynamics, during pressure-controlled ventilation (PCV) or continuous positive airway pressure (CPAP). DESIGN: Bench test and porcine lung injury model. PARTICIPANTS: Twelve bronchoalveolar saline-lavaged pigs. SETTING: Research laboratory in a university hospital. INTERVENTIONS: In a mechanical lung, the efficacy of OSS and CSS with 12 and 14 Fr catheters were compared during volume-control ventilation, PCV, CPAP 0 or 10 cmH(2)O by weighing the suction system before and after aspirating gel in a transparent trachea. Side effects were evaluated in the animals with the same ventilator settings during suctioning of 5, 10 or 20 s duration. MEASUREMENTS AND RESULTS: Suctioning with 12 and 14 Fr catheters was significantly more efficient with OSS (1.9+/-0.1, 2.8+/-0.9 g) and with CSS during CPAP 0 cmH(2)O (1.8+/-0.2, 4.2+/-0.5 g) as compared to CSS during PCV (0.2+/-0.2, 0.8+/-0.3 g) or CPAP 10 cmH(2)O (0.0+/-0.1, 0.7+/-0.4 g), p<0.01 (means +/- SD). OSS and CSS at CPAP 0 cmH(2)O resulted in a marked decrease in SpO(2), mixed venous oxygen saturation and tracheal pressure, p<0.001, but the side effects were considerably fewer during CSS with PCV and CPAP 10 cmH(2)O, p<0.05. CONCLUSIONS: Irrespective of catheter size, OSS and CSS during CPAP 0 cmH(2)O were markedly more effective than CSS during PCV and CPAP 10 cmH(2)O but had worse side effects. However, the side effects lasted less than 5 min in this animal model. Suctioning should be performed effectively when absolutely indicated and the side effects handled adequately.

Analysis of Variance↗
PubMed2004

Changes in lung volume with three systems of endotracheal suctioning with and without pre-oxygenation in patients with mild-to-moderate lung failure.

OBJECTIVE: To compare changes in lung volume, oxygenation, airway pressure, and hemodynamic effects induced by suctioning with three systems in critically ill patients with mild-to-moderate lung disease, and also to evaluate the effects of hyperoxygenation applied prior to the maneuver as suggested by some guidelines. DESIGN: Prospective crossover study. SETTING: General intensive care department of a university-affiliated hospital. PATIENTS: Ten mechanically ventilated patients with mild-to-moderate acute respiratory failure. INTERVENTIONS: Patients were ventilated in volume control mode with a mean tidal volume of 490+/-88 ml, PEEP 7+/-4 cmH2O and FiO(2) 0.36+/-0.05. Suctioning was performed sequentially with a quasi-closed system, with an open system 10 min later, and finally with a closed system. Thereafter, pure oxygen was applied for 2 min and the whole suctioning sequence was repeated in reverse order. MEASUREMENTS AND MAIN RESULTS: Patients' mean PaO(2)/FiO(2) ratio was 273+/-28 mmHg. The reductions in lung volume during suctioning were similar with the quasi-closed (386+/-124 ml) and closed system (497+/-338 ml), but significantly higher with the open system (1281+/-656 ml, P=0.022). We found no significant hemodynamic adverse effects, and no significant SpO(2) reductions with all the studied suctioning techniques. Pre-oxygenation with pure oxygen did not induce additive effects in lung volume changes. With and without pre-oxygenation, lung volume returned to baseline in every patient within 10 min. CONCLUSIONS: Suctioning with closed and quasi-closed systems reduces the substantial losses in lung volume observed with the open system. Nevertheless, in patients without severe lung disease these changes were transient and rapidly reversible.

APACHE↗
PubMed1981

Randomized trial of drainage after cholecystectomy. Suction vaersus static drainage through a main wound versus a stab incision.

One hundred eighty-four patients who underwent biliary surgery were randomly allocated to four groups arranaed in a 2 by 2 design. In 92 patients the drain was brought out through the wound and in the other 92 through a stab incision. In half of the patients in each group the drain was connected to a suction system and in the other half to a sterile bag. Suction was found to impair rather than enhance intraperitoneal drainage. In patients who underwent elective cholecystectomy and early operation for acute cholecystitis, the amount of discharge was more than twice as large when suction was omitted than when it was applied. After common duct operations the amount of discharge was very large and there was little difference in cases with and without suction. Prolonged drainage, static or suction, resulted in an increase in the serum haptoglobin level. Analysis of out data suggested that after a few days the drain starts to act as a traumatic stimulus. No difference was found between cases with the drain brought out through a stab incision and those with the drain brought out through the main wound. A number of studies have ascertained the superiority of closed to open drainage. The results of the present trial lead us to recommend that after biliary surgery the closed us to recommend that after biliary surgery the closed drain should not be connected to a suction apparatus and that after elective cholecystectomy the drain should preferably be removed after a few days.

Adult↗
PubMed2005

Alternate suction reduces prolonged air leak after pulmonary lobectomy: a randomized comparison versus water seal.

BACKGROUND: The objective of the present study was to compare in a prospective randomized fashion two different management schemes for chest tubes after lobectomy: water seal versus alternate suction (suction overnight and water seal during the day). METHODS: Ninety-four patients with air leak on the morning of the first postoperative day were randomly assigned to two groups: group 1 (water seal alone), 47 patients; or group 2 (alternate suction), 47 patients. The groups were then compared in terms of preoperative, operative, and postoperative variables. RESULTS: Alternate suction patients showed a reduced incidence of air leak longer than 4 days (p = 0.04) and longer than 7 days (p = 0.02), a shorter duration of chest tubes in place (p = 0.002), and a shorter postoperative hospital stay (p = 0.004). CONCLUSIONS: Alternate suction was superior to water seal alone in reducing the incidence of prolonged air leak and postoperative hospital stay after lobectomy. As suction was applied only overnight, this modality has the same advantage of water seal in terms of early mobilization of patients.

Aged↗
PubMed2006

Vacuum-assisted apical suction devices induce passive electrical changes consistent with myocardial ischemia during off-pump coronary artery bypass graft surgery.

OBJECTIVE: Off-pump coronary artery bypass graft surgery is common therapy to completely revascularize diseased hearts. In order to graft posterior arteries in this procedure, the heart must be lifted from the chest cavity and manipulated to expose the surgical field using an apical suction device. This suction device may cause unwanted myocardial ischemia. METHODS: In this observational study, we measured myocardial electrical impedance, a parameter that responds to myocardial ischemia, as well as ST-segment changes during off-pump coronary artery bypass graft surgery in 12 patients with two-vessel coronary artery disease undergoing revascularisation of the left anterior descending and the posterior descending coronary arteries. During the posterior descending artery revascularisation phase of the procedure the apical suction device was oriented over the electrodes used to measure myocardial electrical impedance, thus allowing us the opportunity to assess myocardial ischemia in this region of the heart. RESULTS: In these 12 patients, myocardial electrical impedance progressively increased under the suction device during posterior coronary artery revascularisation, suggesting that myocardial ischemia developed in this region of the myocardium. ST-segment changes were negligible while the heart was vertically displaced (and the suction device attached), but increased immediately when the heart was returned to the neutral anatomical position. CONCLUSION: Our data suggest that the apical suction device may cause ischemia while the heart is vertically displaced and electrically disconnected from the body. Under these conditions, ST-segment changes may not detect myocardial ischemia. Myocardial electrical impedance has the potential to reliably detect intraoperative myocardial ischemia under these circumstances.

Coronary Artery Bypass, Off-Pump↗
PubMed1993

Endotracheal suction for adult, non-head-injured, patients. A review of the literature.

The procedure for endotracheal suctioning was perceived as a problem by the members of a quality circle in the intensive care unit (ICU). Endotracheal suction, when performed in the unit, appeared to be carried out according to the nurses' experience and expertise, and had no formal research backing. An extensive literature search was undertaken, and a framework for endotracheal suction was formulated based on the available evidence. Some of the aspects of endotracheal suction represented in the research evidence appear contradictory, and nurses must make a professional judgement about their suction technique based on the individual circumstances of patients. The wealth of evidence available regarding endotracheal suctioning allows nurses to make an informed decision about care.

Critical Care↗
PubMed1997

Microbial colonization of closed-system suction catheters used in liver transplant patients.

The microbial colonization and the associated risk of respiratory infection during the application of a multiple-use closed-system suction catheter (CSSC) and a single-use open-system suction catheter (OSSC) on liver transplant patients was evaluated in this preliminary study. The cost differential for the two systems was also compared. Twenty post-orthotopic liver transplant (OLTx) patients who were mechanically ventilated via an endotracheal (ET) tube were studied. Ten subjects were randomly allocated ET suction by the CSSC and 10 with OSSC. Both groups were similar according to age, sex, clinical severity, presence of a naso-gastric tube, use of H2 antagonists and antibiotics used. Standard protocols were followed to intubate and suction the patients and to change ventilatory equipment. Suctioning performed with the CSSC did not significantly increase the risk of microbial colonization of the respiratory tract. Similarly there was no apparent difference in the incidence of nosocomial pneumonia between the two suction systems, based on the microbiological and clinical data. The mean daily cost of using the CSSC compared to the OSSC was 11.6 times higher. This may be balanced by a reduction in nursing time and reduced risk of spread of infection associated with the CSSC.

Adult↗
PubMed2003

A prospective randomised comparison of cardiotomy suction and cell saver for recycling shed blood during cardiac surgery.

OBJECTIVE: Post-operative neuropsychological complications correlate with intra-operative microemboli in the middle cerebral artery. When severe neurological complications follow cardiac surgery, diffuse cerebral fat emboli are present at autopsy. Recycling shed blood with cardiotomy suction is an important source of cerebral fat microemboli. A cell saver may reduce this. METHODS: Twenty patients were prospectively randomised to assess the amount of fat in blood salvaged from the pericardium and returned to the patient with either cell saver or cardiotomy suction. Blood samples were taken before and after filtration in the cardiotomy suction group or cell saver processing in the cell saver group. After centrifuging samples, fat content was graded on a scale of 0-3 by a blinded independent observer. Fat content was also quantified by weight. RESULTS: Compared with cardiotomy suction, cell saver removed significantly more fat from shed blood. Median fat grading after cell saver was 0 (0-1) compared with 1 (1-2) for cardiotomy suction (P=0.0001). Percentage reduction in fat weight achieved by cell saver or cardiotomy suction was 87% compared to 45% (P=0.007). There was no difference in the post-operative use of blood or blood products, haemoglobin, or bleeding between the two groups. CONCLUSION: Use of cell saver results in less fat being recycled during cardiopulmonary bypass.

Aged↗