The inflammatory response to cardiopulmonary bypass: part 2--anti-inflammatory therapeutic strategies.

摘要

CARDIOPULMONARY BYPASS (CPB) REMAINS an integral part of many cardiothoracic procedures but is known to cause an undesirable inflammatory reaction. In most circumstances, the resulting organ dysfunction is transient and self-terminating because the homeostatic defense mechanisms are able to compensate. On occasion, however, the patient may experience major complications, increased intensive care and hospital length-of-stay, and even death.The following elements of cardiac surgery and CPB predispose patients (many with pre-existing morbidity) to an undesirable inflammatory response and these elements will, to some extent, always remain: surgical trauma, body temperature fluctuations, ischemia-reperfusion injury, blood product transfusions, hemodilution, and the exposure of blood to nonendothe-lial surfaces. Part 1 of this article published in the prior issue of this journal describes the cellular and humoral pathogenesis that drives this response.