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Treatment of sepsis in cardiac surgery: role of immunoglobulins

Clinic of Anaesthesiology and Intensive Care Medicine, Martin-Luther-University, Halle/Wittenberg

J Mühling

Department of Anaesthesiology and Intensive Care Medicine, Justus-Liebig-University, Giessen

M G Dehne

Department of Anaesthesiology and Intensive Care Medicine, Justus-Liebig-University, Giessen

B Zickmann

Department of Anaesthesiology and Intensive Care Medicine, Justus-Liebig-University, Giessen

R E Silber

Clinic of Cardiothoracic Surgery, Martin-Luther-University, Halle/Wittenberg

I Friedrich

Clinic of Cardiothoracic Surgery, Martin-Luther-University, Halle/Wittenberg

Cardiopulmonary bypass (CPB) is associated with an injury that may cause pathophysiological changes such as systemic inflammatory response syndrome, multiple organ dysfunction syndrome, and mediator-induced multiorgan failure. Systemic endotoxinaemia, release of proinflammatory cytokines, and interactions between neutrophils and endothelium have been reported to correlate with a high incidence of organ dysfunction, infection and sepsis following cardiac surgery. This review discusses the dysregulation of the immune response as a major reason for the higher susceptibility to infections following cardiac surgery, various treatment strategies to reduce CPB-induced inflammation, and especially the prophylactic use of immunoglobulins in cardiac surgery.

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