Key Points for Curbing Cardiopulmonary Bypass Inflammation
Acta cir. bras
;
31(supl.1): 45-52, 2016. tab, graf
Artículo
en Inglés
| LILACS
| ID: lil-779763
ABSTRACT
PURPOSE: Cardiopulmonary bypass (CPB) procedures are thought to activate systemic inflammatory reaction syndrome (SIRS). Strategies to curb systemic inflammation have been previously described. However, none of them is adequate, since "curbing" the extent of the inflammatory response requires a multimodal approach. The aim of the present mini-review is to discuss the main key points about the main principles in cardiopulmonary bypass curbing inflammation. METHODS: No systematic literature search (MEDLINE) and extracted data from the accumulated experience of the authors. The preconceived idea of an association between severe inflammation and coagulation disorders is reviewed. Also, some fundamental concepts, CPB inflammatory biomarkers, the vasoplegic syndrome and the need forindividual CPB protocols for children, diabetes and old patients, are discussed. CONCLUSION: The ways in which surgical technique (atraumatic vein harvest, biocompatibility and shear resistance of the circuit, monitoring, minimizing organ ischemia, minimal cross-clamping trauma, and blood management) are thought to curb SIRS induced by CPB and affect positively the patient outcome.Improved patient outcomes are strongly associated with these modalities of care, more than single or combinatorial drug strategies (aprotinin, tranexamic acid, pentoxifylline) or CPB modalities (minicircuits, heparin-coated circuits, retrograde autologous prime).
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Puente Cardiopulmonar
/
Síndrome de Respuesta Inflamatoria Sistémica
Tipo de estudio:
Estudio de etiología
Límite:
Humanos
Idioma:
Inglés
Revista:
Acta cir. bras
Asunto de la revista:
Cirugía General
/
Procedimentos Cir£rgicos Operat¢rios
Año:
2016
Tipo del documento:
Artículo
País de afiliación:
Brasil
Institución/País de afiliación:
University of São Paulo/BR
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