TY - CHAP
T1 - Inflammatory response and minimized cardiopulmonary bypass
AU - Olivencia-Yurvati, A. H.
AU - Mallet, R. T.
N1 - Funding Information:
Work by the authors reported herein was supported by grants from the Osteopathic Heritage Foundation (02-18-522), the United States Department of Defense (W911NF-09-1-0086) and the University of North Texas Health Science Center (G67716, G97001). The authors are indebted to the many talented colleagues, students and technical staff who contributed to this work.
PY - 2012/4
Y1 - 2012/4
N2 - Approaches are described for dealing with the massive systemic inflammatory response induced by cardiopulmonary bypass (CPB), which, if unchecked, inflicts end-organ damage culminating in significant postoperative morbidity and mortality. Clinical trials of pharmacological antioxidants, e.g. N-. acetylcysteine, are described and the use of cardioplegia enriched with pyruvate, a physiological energy substrate and antioxidant, which exerts a host of anti-inflammatory effects in a swine CPB model, is shown to afford robust post-CPB recovery in patients undergoing coronary revascularization on-pump. The advantages of miniaturized extracorporeal CPB systems, which minimize blood contact with the extracorporeal circuit and limit priming volume, and thus hemodilution, are examined. The benefits include reductions in circulating proinflammatory cytokines and activated neutrophils, incidence of atrial fibrillation, and duration of postoperative hospitalization.
AB - Approaches are described for dealing with the massive systemic inflammatory response induced by cardiopulmonary bypass (CPB), which, if unchecked, inflicts end-organ damage culminating in significant postoperative morbidity and mortality. Clinical trials of pharmacological antioxidants, e.g. N-. acetylcysteine, are described and the use of cardioplegia enriched with pyruvate, a physiological energy substrate and antioxidant, which exerts a host of anti-inflammatory effects in a swine CPB model, is shown to afford robust post-CPB recovery in patients undergoing coronary revascularization on-pump. The advantages of miniaturized extracorporeal CPB systems, which minimize blood contact with the extracorporeal circuit and limit priming volume, and thus hemodilution, are examined. The benefits include reductions in circulating proinflammatory cytokines and activated neutrophils, incidence of atrial fibrillation, and duration of postoperative hospitalization.
KW - Atrial fibrillation
KW - Cardioplegia
KW - Inflammation
KW - Minimized cardiopulmonary bypass
UR - http://www.scopus.com/inward/record.url?scp=84903814063&partnerID=8YFLogxK
U2 - 10.1016/B978-1-84569-800-3.50006-1
DO - 10.1016/B978-1-84569-800-3.50006-1
M3 - Chapter
AN - SCOPUS:84903814063
SN - 9781845698003
SP - 86
EP - 112
BT - Minimized Cardiopulmonary Bypass Techniques and Technologies
PB - Elsevier Inc.
ER -