• Ronald A Bronicki and Mark Hall.
• 1Department of Pediatrics, Section of Critical Care Medicine and Cardiology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX. 2Department of Pediatrics, Section of Critical Care Medicine, Ohio State College of Medicine, Nationwide Children's Hospital, Columbus, OH.
• Pediatr Crit Care Me. 2016 Aug 1; 17 (8 Suppl 1): S272-8.

ObjectivesThe objectives of this review are to discuss the pathophysiology of the pro-inflammatory response to the cardiopulmonary bypass circuit, the impact of ischemia reperfusion injury on post-operative organ function, the compensatory anti-inflammatory response and the evidence for immune-modulatory strategies and their impact on outcomes.Data SourceMEDLINE, PubMed.ConclusionInnovations such as the development of more biocompatible surfaces and miniaturized circuits, as well as the increasing expertise of surgeons, anesthesiologists and perfusionists has transformed cardiac surgery and the use of cardiopulmonary bypass into a relatively routine procedure with favorable outcomes. Despite these refinements, the attendant inflammatory response to bypass, ischemia reperfusion injury and the compensatory anti-inflammatory response contribute to post-operative morbidity and mortality. Additional studies are needed to further delineate the impact of immunomodulatory strategies on outcomes.

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