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 Google Scholar Articles by de Vroege, R Articles by van Oeveren, W Search for Related Content PubMed PubMed Citation Articles by de Vroege, R Articles by van Oeveren, W Social Bookmarking                   What's this?

Induction and detection of disturbed homeostasis in cardiopulmonary bypass

Department of Extracorporeal Circulation, Vrije Universiteit Medisch Centrum, Amsterdam, The Netherlands, r.devroege{at}azvu.nl

F te Meerman

OLVG Hospital, Amsterdam, The Netherlands

L Eijsman

Department of Cardiac Surgery, Vrije Universiteit Medisch Centrum, Amsterdam, The Netherlands

W R Wildevuur

Department of Extracorporeal Circulation, Vrije Universiteit Medisch Centrum, Amsterdam, The Netherlands

Ch RH Wildevuur

Department of Cardiac Surgery, Vrije Universiteit Medisch Centrum, Amsterdam, The Netherlands

W van Oeveren

Department of Biomaterials, University of Groningen, Groningen, The Netherlands

During cardiopulmonary bypass (CPB) haemodynamic alterations, haemostasis and the inflammatory response are the main causes of homeostatic disruption. Even with CPB procedures of short duration, the homeostasis of a patient is disrupted and, in many cases, requires intensive postoperative treatment to re-establish the physiological state of the patient. Although mortality is low, disruption of homeostasis may contribute to increased morbidity, particularly in high-risk patients. Over the past decades, considerable technical improvements in CPB equipment have been made to prevent the development of the systemic inflammatory response syndrome (SIRS). Despite all these improvements, only the inflammatory response, to some extent, has been reduced. The microcirculation is still impaired, as measured by tissue degradation products of various organs, indicating that CPB may still be considered as an unphysiological procedure. The question is, therefore, whether we can detect the pathophysiological consequences of CPB in each individual patient with valid bedside markers, and whether we can relate this to determinant factors in the CPB procedure in order to assist the perfusionist in improving the adequacy of CPB. The use of these markers could play a pivotal role in decision making by providing an immediate feedback on the determinant quality of perfusion. Therefore, we suggest validating the proposed markers in a nomogram to optimize not only the CPB procedure, but also the patient’s safety.

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

This article has been cited by other articles:

				G. Niranjan, G. Asimakopoulos, A. Karagounis, G. Cockerill, M. Thompson, and V. Chandrasekaran Effects of cell saver autologous blood transfusion on blood loss and homologous blood transfusion requirements in patients undergoing cardiac surgery on- versus off-cardiopulmonary bypass: a randomised trial. Eur. J. Cardiothorac. Surg., August 1, 2006; 30(2): 271 - 277. [Abstract] [Full Text] [PDF]