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Ann Thorac Surg 1993;55:552-559
© 1993 The Society of Thoracic Surgeons


Articles

Inflammatory response to cardiopulmonary bypass

John Butler, FRCSI*, Graeme M. Rocker, MRCP, Stephen Westaby, FRCS

Department of Cardiothoracic Surgery, Oxford Heart Centre, John Radcliffe Hospital, Oxford, England

* Address reprint requests to Dr Butler, Department of Cardiothoracic Surgery, Oxford Heart Centre, John Radcliffe Hospital, Headington, Oxford OX3 9DU, England.

Cardiac operations with cardiopulmonary bypass cause a systemic inflammatory response, which can lead to organ injury and postoperative morbidity. Causative factors include surgical trauma, contact of blood with the extracorporeal circuit, and lung reperfusion injury on discontinuing bypass. Advances in immunological techniques have allowed measurement of both plasma and intracellular components of this multifaceted perioperative response. This includes activation of the complement, coagulation, fibrinolytic, and kallikrein cascades, activation of neutrophils with degranulation and protease enzyme release, oxygen radical production, and the synthesis of various cytokines from mononuclear cells (including tumor necrosis factor, interleukin-1, and interleukin-6). Advances in our understanding of the interactions between these markers of cellular and humoral responses to cardiopulmonary bypass will enable more effective intervention to reduce the deleterious effects and improve the outlook for patients undergoing cardiac operations beyond the 1990s.




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PerfusionHome page
J. B. Moreno, S. Margraf, A. M Schuller, A Simon, A Moritz, and M Scholz
Inhibition of neutrophil activity in cardiac surgery with cardiopulmonary bypass: a novel strategy with the leukocyte inhibition module
Perfusion, January 1, 2004; 19(1): 11 - 16.
[Abstract] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
M. Gaudino, A. Di Castelnuovo, R. Zamparelli, F. Andreotti, F. Burzotta, L. Iacoviello, F. Glieca, F. Alessandrini, G. Nasso, M. B. Donati, et al.
Genetic control of postoperative systemic inflammatory reaction and pulmonary and renal complications after coronary artery surgery
J. Thorac. Cardiovasc. Surg., October 1, 2003; 126(4): 1107 - 1112.
[Abstract] [Full Text] [PDF]


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HeartHome page
R A Archbold and N P Curzen
Off-pump coronary artery bypass graft surgery: the incidence of postoperative atrial fibrillation
Heart, October 1, 2003; 89(10): 1134 - 1137.
[Abstract] [Full Text] [PDF]


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PerfusionHome page
J. Noora, A. Lamy, K. M Smith, R. Kent, D. Batt, J. Fedoryshyn, and X. Wang
The effect of oxygenator membranes on blood: a comparison of two oxygenators in open-heart surgery
Perfusion, September 1, 2003; 18(5): 313 - 320.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
H. Huang, T. Yao, W. Wang, D. Zhu, W. Zhang, H. Chen, and W. Fu
Continuous ultrafiltration attenuates the pulmonary injury that follows open heart surgery with cardiopulmonary bypass
Ann. Thorac. Surg., July 1, 2003; 76(1): 136 - 140.
[Abstract] [Full Text] [PDF]


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Eur J Cardiothorac SurgHome page
D. Shum-Tim, C. I. Tchervenkov, E. Laliberte, A.-M. Jamal, T. Nimeh, C.-Y. Luo, B. Bittira, and A. Philip
Timing of steroid treatment is important for cerebral protection during cardiopulmonary bypass and circulatory arrest: minimal protection of pump prime methylprednisolone
Eur J Cardiothorac Surg, July 1, 2003; 24(1): 125 - 132.
[Abstract] [Full Text] [PDF]


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Eur J Cardiothorac SurgHome page
L. Hadjinikolaou, C. Alexiou, A. S. Cohen, R. D. L. Standbridge, A. J. McColl, and W. Richmond
Early changes in plasma antioxidant and lipid peroxidation levels following coronary artery bypass surgery: a complex response
Eur J Cardiothorac Surg, June 1, 2003; 23(6): 969 - 975.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
J. M. Costello, C. L. Backer, A. de Hoyos, H. J. Binns, and C. Mavroudis
Aprotinin reduces operative closure time and blood product use after pediatric bypass
Ann. Thorac. Surg., April 1, 2003; 75(4): 1261 - 1266.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
M. Ninomiya, K. Miyaji, and S. Takamoto
Influence of PMEA-coated bypass circuits on perioperative inflammatory response
Ann. Thorac. Surg., March 1, 2003; 75(3): 913 - 917.
[Abstract] [Full Text] [PDF]


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PerfusionHome page
A. J de Vries, Y J. Gu, W. J Post, P. Vos, I. Stokroos, H. Lip, and W. van Oeveren
Leucocyte depletion during cardiac surgery: a comparison of different filtration strategies
Perfusion, January 1, 2003; 18(1): 31 - 38.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
R. Ascione, M. Caputo, and G. D. Angelini
Off-pump coronary artery bypass grafting: not a flash in the pan
Ann. Thorac. Surg., January 1, 2003; 75(1): 306 - 313.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
M. Caputo, M. Yeatman, P. Narayan, G. Marchetto, R. Ascione, B. C. Reeves, and G. D. Angelini
Effect of off-pump coronary surgery with right ventricular assist device on organ function and inflammatory response: a randomized controlled trial
Ann. Thorac. Surg., December 1, 2002; 74(6): 2088 - 2095.
[Abstract] [Full Text] [PDF]


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Asian Cardiovasc. Thorac. Ann.Home page
E. Naseri and M. Sevinc
Comparison of Off-Pump Versus Conventional Coronary Revascularization
Asian Cardiovasc Thorac Ann, December 1, 2002; 10(4): 322 - 325.
[Abstract] [Full Text] [PDF]


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Eur J Cardiothorac SurgHome page
Y. Fromes, D. Gaillard, O. Ponzio, M. Chauffert, M.-F. Gerhardt, P. Deleuze, and O. M. Bical
Reduction of the inflammatory response following coronary bypass grafting with total minimal extracorporeal circulation
Eur J Cardiothorac Surg, October 1, 2002; 22(4): 527 - 533.
[Abstract] [Full Text] [PDF]


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CirculationHome page
R. Ascione, B. C. Reeves, K. Rees, and G. D. Angelini
Effectiveness of Coronary Artery Bypass Grafting With or Without Cardiopulmonary Bypass in Overweight Patients
Circulation, October 1, 2002; 106(14): 1764 - 1770.
[Abstract] [Full Text] [PDF]


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CirculationHome page
N. K. Chanani, D. B. Cowan, K. Takeuchi, D. N. Poutias, L. M. Garcia, P. J. del Nido, and F. X. McGowan Jr
Differential Effects of Amrinone and Milrinone Upon Myocardial Inflammatory Signaling
Circulation, September 24, 2002; 106(12_suppl_1): I-284 - I-289.
[Abstract] [Full Text] [PDF]


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Anesth. Analg.Home page
G. Zilberstein, R. Levy, M. Rachinsky, A. Fisher, L. Greemberg, Y. Shapira, A. Appelbaum, and L. Roytblat
Ketamine Attenuates Neutrophil Activation After Cardiopulmonary Bypass
Anesth. Analg., September 1, 2002; 95(3): 531 - 536.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
J. Butler, E. W. Murithi, V. L. Pathi, K. J.D. MacArthur, and G. A. Berg
Duroflo II heparin bonding does not attenuate cytokine release or improve pulmonary function
Ann. Thorac. Surg., July 1, 2002; 74(1): 139 - 142.
[Abstract] [Full Text] [PDF]


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PerfusionHome page
R. Ascione, S. Al-Ruzzeh, K. Amer, and G. D Angelini
Subsystem organ function during coronary surgery
Perfusion, July 1, 2002; 17(4): 295 - 303.
[Abstract] [PDF]


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Eur J Cardiothorac SurgHome page
B. Meyns, R. Autschbach, A. Boning, W. Konertz, K. Matschke, F. Schondube, K. Wiebe, and E. Fischer
Coronary artery bypass grafting supported with intracardiac microaxial pumps versus normothermic cardiopulmonary bypass: a prospective randomized trial
Eur J Cardiothorac Surg, July 1, 2002; 22(1): 112 - 117.
[Abstract] [Full Text] [PDF]


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Br J AnaesthHome page
S. R. El Azab, P. M. J. Rosseel, J. J. de Lange, A. B. J Groeneveld, R. van Strik, E. M. van Wijk, and G. J. Scheffer
Dexamethasone decreases the pro- to anti-inflammatory cytokine ratio during cardiac surgery
Br. J. Anaesth., April 1, 2002; 88(4): 496 - 501.
[Abstract] [Full Text] [PDF]


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PerfusionHome page
G. Asimakopoulos
The inflammatory response to CPB: the role of leukocyte filtration
Perfusion, March 1, 2002; 17(2_suppl): 7 - 10.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
M. Chello, P. Mastroroberto, A. Quirino, G. Cuda, F. Perticone, F. Cirillo, and E. Covino
Inhibition of neutrophil apoptosis after coronary bypass operation with cardiopulmonary bypass
Ann. Thorac. Surg., January 1, 2002; 73(1): 123 - 129.
[Abstract] [Full Text] [PDF]


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PerfusionHome page
K McCusker, V Vijay, W DeBois, R Helm, and D Sisto
MAST system: a new condensed cardiopulmonary bypass circuit for adult cardiac surgery
Perfusion, December 1, 2001; 16(6): 447 - 452.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
E. Tayama, N. Hayashida, S. Fukunaga, K. Tayama, T. Takaseya, R. Hiratsuka, and S. Aoyagi
High-dose cimetidine reduces proinflammatory reaction after cardiac surgery with cardiopulmonary bypass
Ann. Thorac. Surg., December 1, 2001; 72(6): 1945 - 1949.
[Abstract] [Full Text] [PDF]


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Ann. Thorac. Surg.Home page
R. Ascione, G. Nason, S. Al-Ruzzeh, C. Ko, F. Ciulli, and G. D. Angelini
Coronary revascularization with or without cardiopulmonary bypass in patients with preoperative nondialysis-dependent renal insufficiency
Ann. Thorac. Surg., December 1, 2001; 72(6): 2020 - 2025.
[Abstract] [Full Text] [PDF]


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J. Thorac. Cardiovasc. Surg.Home page
A. D. Chishti, J. H. Dark, P. Kesteven, H. Powell, C. Snowden, B. K. Shenton, J. A. Kirby, and S. V. Baudouin
Expression of chemokine receptors CXCR1 and CXCR2 during cardiopulmonary bypass
J. Thorac. Cardiovasc. Surg., December 1, 2001; 122(6): 1162 - 1166.
[Abstract] [Full Text] [PDF]


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SEMIN CARDIOTHORAC VASC ANESTHHome page
H. A. Hennein
Inflammation After Cardiopulmonary Bypass: Therapy for the Postpump Syndrome
Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2001; 5(3): 236 - 255.
[Abstract] [PDF]


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SEMIN CARDIOTHORAC VASC ANESTHHome page
E. Appachi and E. B. Mossad
Inflammatory Mediators and S-100{beta} Protein Concentrations in Neonates and Infants With Congenital Heart Disease
Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2001; 5(3): 256 - 261.
[Abstract] [PDF]


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PerfusionHome page
G Matheis, M Scholz, A Simon, O. Dzemali, and A Moritz
Leukocyte filtration in cardiac surgery: a review
Perfusion, September 1, 2001; 16(5): 361 - 370.
[Abstract] [PDF]


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Ann. Thorac. Surg.Home page
V. Casati, C. Gerli, A. Franco, G. Torri, A. D'Angelo, S. Benussi, and O. Alfieri
Tranexamic acid in off-pump coronary surgery: a preliminary, randomized, double-blind, placebo-controlled study
Ann. Thorac. Surg., August 1, 2001; 72(2): 470 - 475.
[Abstract] [Full Text] [PDF]




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