Devices

1. Cardiotomy x 2: ‘Blue’, ‘Clear’
2. Cardiac Vent x 1: ‘Green’
3. Cell Salvage (ICS) x 1
4. Wall/generic suction

Suction tips

• Plastic vs. Metal
• Yankauer vs  Coronary/small

Principles

1. On CPB, Cardiotomy suction to catch all bleeding except:
   • Topical cooling solution – can cause haemodilution
   • Low visibility – use ICS, if not adequate, use wall sucker as well
   • Debris (e.g. irrigation of calcified aorta/valves) – use wall sucker (? although ICS is equipped to deal with debris)
2. Off CPB, Cell salvage for all bleeding except:
   • Low visibility – use wall sucker as well
   • Post-heparinisation before venous cannulation – can use cardiotomy suction, especially if going on sucker bypass
   • ?Debris – ?ICS is equipped to deal with debris

Methods of creating vacuum to suck

1. Roller pump
2. Piston-cylinder – cycles a diaphragm that moves up and down à increases volume, creates negative pressure. E.g. wall suction
3. Siphon principle

• High rates of contamination of suction tips during intraoperative period
• Changing of suction tip ?every hour, ?before entering special area
• However, no correlation between SSI and contamination of tip