ABSTRACT
Neurocognitive dysfunction is a common postoperative complication exacerbated by cardiopulmonary bypass triggering a systemic inflammatory response. This clinical column focuses on the up-regulation of endogenous erythropoietin related to neurological inflammation and the use of recombinant erythropoietin as a neuroprotective pharmacotherapeutic agent.
Subject(s)
Cardiac Surgical Procedures/adverse effects , Cognition Disorders/prevention & control , Erythropoietin/therapeutic use , Hematinics/therapeutic use , Cognition Disorders/etiology , Erythropoietin/metabolism , Humans , Hypoxia/metabolism , Hypoxia/physiopathology , Inflammation/metabolism , Inflammation/physiopathology , Recombinant ProteinsABSTRACT
The road to publication often seems complicated for newer authors. Therefore, in this column, the authors will clarify the publication process. Topics including why publication is important, choosing a journal, preparing the manuscript-as well as some tips for writing and understanding and responding to peer review-are addressed.
Subject(s)
Nursing Research/organization & administration , Peer Review, Research , Periodicals as Topic , Writing , Humans , Peer Review, Research/methods , Professional Competence/standardsABSTRACT
Cardiopulmonary bypass results in activation of the coagulation, fibrinolytic, inflammatory, and complement cascades. These activated cascades result in a decrease in the number of circulating coagulation factors, hyperfibrinolysis, thrombocytopenia, platelet defects, coagulopathies, and an acute inflammatory response. Patients experiencing cardiac surgery with cardiopulmonary bypass are at risk for many potential problems. The use of aprotinin, an antifibrinolytic agent, has multiple effects that tend to reduce hematological defects and blunts the inflammatory response that is associated with cardiac surgery. The pathophysiological consequences of cellular activation associated with cardiopulmonary bypass, basic mechanisms of action of aprotinin, pharmacodynamic and pharmacokinetic properties, dosing, adverse reactions, and cost/benefit ratio are discussed in this article. Critical care nurses need to know about aprotinin to understand its role in reducing blood loss and transfusions during and after cardiac surgery.
