This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Asimakopoulos, G. Search for Related Content PubMed PubMed Citation Articles by Asimakopoulos, G. Social Bookmarking                   What's this?

Systemic inflammation and cardiac surgery: an update

Specialist Registrar in Cardiothoracic Surgery, Cardiothoracic Department, Imperial College School of Medicine at Hammersmith Hospital, Du Cane Road, London, geoasi{at}hotmail.com

Cardiac surgery with cardiopulmonary bypass (CPB) is associated with the development of a systemic inflammatory response that can often lead to dysfunction of major organs. The systemic inflammation can be assessed intra- and postoperatively by measuring concentrations of inflammatory mediators in plasma and tissues. These concentrations, however, do not always correlate with the degree of observed organ dysfunction.

Various strategies have been used to reduce inflammatory phenomena in patients undergoing CPB. Cardiac surgery without CPB has been performed increasingly with satisfactory results over the past few years. Attenuation of systemic inflammation and improved outcome in high risk patients are potential benefits of this technique.

The emergence and expanding performance of cardiac surgical procedures without the use of CPB has given us an excellent tool to investigate the relative importance of CPB as a cause of systemic inflammation.

Aprotinin is a protease inhibitor which is used in cardiac surgical patients for its haemostatic effects. Aprotinin has anti-inflammatory properties, the nature of which have not been completely clarified.

This article presents a summary of the published literature investigating inflammatory response and organ dysfunction in patients who have cardiac surgery without CPB. It also presents an overview of recent data on the anti-inflammatory action mechanisms of aprotinin.

Perfusion, Vol. 16, No. 5, 353-360 (2001)
DOI: 10.1177/026765910101600505


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				U. Goebel, M. Siepe, A. Mecklenburg, T. Doenst, F. Beyersdorf, T. Loop, and C. Schlensak Reduced pulmonary inflammatory response during cardiopulmonary bypass: effects of combined pulmonary perfusion and carbon monoxide inhalation Eur. J. Cardiothorac. Surg., December 1, 2008; 34(6): 1165 - 1172. [Abstract] [Full Text] [PDF]

				D. G. Healy, A. E. Wood, A. O'Neill, J. F. McCarthy, J. M. Fitzpatrick, and R. W. Watson Can preoperative modelling of individual neutrophil adhesion responses predict renal morbidity? Eur. J. Cardiothorac. Surg., June 1, 2007; 31(6): 1088 - 1093. [Abstract] [Full Text] [PDF]

				D. Pacini, A. Leone, L. Di Marco, D. Marsilli, F. Sobaih, S. Turci, V. Masieri, and R. Di Bartolomeo Antegrade selective cerebral perfusion in thoracic aorta surgery: safety of moderate hypothermia Eur. J. Cardiothorac. Surg., April 1, 2007; 31(4): 618 - 622. [Abstract] [Full Text] [PDF]

				J. Tatoulis, S. Rice, P. Davis, J. C. Goldblatt, and S. Marasco Patterns of postoperative systemic vascular resistance in a randomized trial of conventional on-pump versus off-pump coronary artery bypass graft surgery. Ann. Thorac. Surg., October 1, 2006; 82(4): 1436 - 1444. [Abstract] [Full Text] [PDF]

				G. Nollert, I. Schwabenland, D. Maktav, F. Kur, F. Christ, P. Fraunberger, B. Reichart, and C. Vicol Miniaturized Cardiopulmonary Bypass in Coronary Artery Bypass Surgery: Marginal Impact on Inflammation and Coagulation but Loss of Safety Margins Ann. Thorac. Surg., December 1, 2005; 80(6): 2326 - 2332. [Abstract] [Full Text] [PDF]

				S. G Raja and G. D Dreyfus Modulation of Systemic Inflammatory Response after Cardiac Surgery Asian Cardiovasc Thorac Ann, December 1, 2005; 13(4): 382 - 395. [Abstract] [Full Text] [PDF]

				G. Asimakopoulos, A. P. Karagounis, O. Valencia, N. Alexander, M. Howlader, M. A. Sarsam, and V. Chandrasekaran Renal Function After Cardiac Surgery Off- Versus On-Pump Coronary Artery Bypass: Analysis Using the Cockroft-Gault Formula for Estimating Creatinine Clearance Ann. Thorac. Surg., June 1, 2005; 79(6): 2024 - 2031. [Abstract] [Full Text] [PDF]

				A. Chung, S. M. Wildhirt, S. Wang, A. Koshal, and M. W. Radomski Combined administration of nitric oxide gas and iloprost during cardiopulmonary bypass reduces platelet dysfunction: A pilot clinical study J. Thorac. Cardiovasc. Surg., April 1, 2005; 129(4): 782 - 790. [Abstract] [Full Text] [PDF]

				C. Alexiou, A. A.T. Tang, S. V. Sheppard, D. C. Smith, R. Gibbs, S. A. Livesey, J. L. Monro, and M. P. Haw The effect of leucodepletion on leucocyte activation, pulmonary inflammation and respiratory index in surgery for coronary revascularisation: a prospective randomised study Eur. J. Cardiothorac. Surg., August 1, 2004; 26(2): 294 - 300. [Abstract] [Full Text] [PDF]

				P. C. Papageorgiou, A. Pourdjabbar, A. A. Amfilochiadis, E. P. Diamandis, F. Boomsma, and D. H. Osmond Are cardiovascular and sympathoadrenal effects of human "new pressor protein" preparations attributable to human coagulation {beta}-FXIIa? Am J Physiol Heart Circ Physiol, March 1, 2004; 286(3): H837 - H846. [Abstract] [Full Text] [PDF]

				W. Eichler, M. J. Bechtel, S. Klaus, M. Heringlake, M. Hernandez, K. Toerber, K.-F. Klotz, and C. Bartels Na+/H+exchange inhibitor cariporide: effects on respiratory dysfunction after cardiopulmonary bypass Perfusion, January 1, 2004; 19(1): 33 - 40. [Abstract] [PDF]

				K. G. Engstrom Contaminating fat in pericardial suction blood: a clinical, technical and scientific challenge Perfusion, January 1, 2004; 19(1_suppl): S21 - S31. [Abstract] [PDF]

				T. Goto, T. Baba, K. Matsuyama, K. Honma, M. Ura, and T. Koshiji Aortic atherosclerosis and postoperative neurological dysfunction in elderly coronary surgical patients Ann. Thorac. Surg., June 1, 2003; 75(6): 1912 - 1918. [Abstract] [Full Text] [PDF]

				M Chello, P Mastroroberto, G Patti, A D'Ambrosio, M C. Morichetti, G Di Sciascio, and E Covino Simvastatin attenuates leucocyte-endothelial interactions after coronary revascularisation with cardiopulmonary bypass Heart, May 1, 2003; 89(5): 538 - 543. [Abstract] [Full Text] [PDF]

				G. Asimakopoulos and T. Gourlay A review of anti-inflammatory strategies in cardiac surgery Perfusion, January 1, 2003; 18(1_suppl): 7 - 12. [Abstract] [PDF]