• Best Pract Res Clin Anaesthesiol · Jun 2015

    Review

    Inflammatory response and extracorporeal circulation.

    • Florian Kraft, Christoph Schmidt, Hugo Van Aken, and Alexander Zarbock.
    • Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Münster, Germany. Electronic address: kraftf@uni-muenster.de.
    • Best Pract Res Clin Anaesthesiol. 2015 Jun 1; 29 (2): 113-23.

    AbstractPatients undergoing cardiac surgery with extracorporeal circulation (EC) frequently develop a systemic inflammatory response syndrome. Surgical trauma, ischaemia-reperfusion injury, endotoxaemia and blood contact to nonendothelial circuit compounds promote the activation of coagulation pathways, complement factors and a cellular immune response. This review discusses the multiple pathways leading to endothelial cell activation, neutrophil recruitment and production of reactive oxygen species and nitric oxide. All these factors may induce cellular damage and subsequent organ injury. Multiple organ dysfunction after cardiac surgery with EC is associated with an increased morbidity and mortality. In addition to the pathogenesis of organ dysfunction after EC, this review deals with different therapeutic interventions aiming to alleviate the inflammatory response and consequently multiple organ dysfunction after cardiac surgery. Copyright © 2015 Elsevier Ltd. All rights reserved.

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