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Ann Thorac Surg 1999;68:1107-1115
© 1999 The Society of Thoracic Surgeons
a Cardiothoracic Unit, Imperial College School of Medicine at Hammersmith Hospital, London, England, UK
Address reprint requests to Dr Taylor, Cardiothoracic Unit, Imperial College School of Medicine at Hammersmith Hospital, Du Cane Rd, London W12 0NN, England
e-mail: scarroll{at}rpms.ac.uk
Cardiopulmonary bypass is often followed by pulmonary dysfunction as assessed by measuring the alveolar-arterial oxygenation gradient, intrapulmonary shunt, degree of pulmonary edema, pulmonary compliance, and pulmonary vascular resistance. It is also regarded as a risk factor for development of acute respiratory distress syndrome. On the other hand, cardiopulmonary bypass is associated with a whole body inflammatory response, which involves activation of complement, leukocytes, and endothelial cells with secretion of cytokines, proteases, arachidonic acid metabolites, and oxygen free radicals. Leukocyte adhesion to microvascular endothelium, leukocyte extravasation, and tissue damage are the final steps. Although the inflammatory response to cardiopulmonary bypass often remains at subclinical levels, it can also lead to major organ dysfunction and multiple organ failure. This review article summarizes the recent literature on the molecular and cellular mechanisms involved in the phenomenon of pulmonary dysfunction after cardiopulmonary bypass. It also summarizes reports on the prevalence and mortality of acute respiratory distress syndrome after cardiac surgery.
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P. Giomarelli, S. Scolletta, E. Borrelli, and B. Biagioli Myocardial and lung injury after cardiopulmonary bypass: role of interleukin (IL)-10 Ann. Thorac. Surg., July 1, 2003; 76(1): 117 - 123. [Abstract] [Full Text] [PDF]
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R Fink, M Al-Obaidi, S Grewal, M Winter, and J Pepper Monocyte activation markers during cardiopulmonary bypass Perfusion, March 1, 2003; 18(2): 83 - 86. [Abstract] [PDF]
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C. S.H. Ng, S. Wan, A. P.C. Yim, and A. A. Arifi Pulmonary Dysfunction After Cardiac Surgery* Chest, April 1, 2002; 121(4): 1269 - 1277. [Abstract] [Full Text] [PDF]
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M. A. Chaney Corticosteroids and Cardiopulmonary Bypass : A Review of Clinical Investigations Chest, March 1, 2002; 121(3): 921 - 931. [Abstract] [Full Text] [PDF]
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G. Asimakopoulos Systemic inflammation and cardiac surgery: an update Perfusion, September 1, 2001; 16(5): 353 - 360. [Abstract] [PDF]
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G. Asimakopoulos, E. A. Lidington, J. Mason, D. O. Haskard, K. M. Taylor, and R. C. Landis Effect of aprotinin on endothelial cell activation J. Thorac. Cardiovasc. Surg., July 1, 2001; 122(1): 123 - 128. [Abstract] [Full Text] [PDF]
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K. D. Chinsky Critical Interactions : Man and Machine Chest, April 1, 2001; 119(4): 996 - 997. [Full Text] [PDF]
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M. A. Chaney, R. A. Durazo-Arvizu, M. P. Nikolov, B. P. Blakeman, and M. Bakhos Methylprednisolone does not benefit patients undergoing coronary artery bypass grafting and early tracheal extubation J. Thorac. Cardiovasc. Surg., March 1, 2001; 121(3): 561 - 569. [Abstract] [Full Text] [PDF]
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V. R. Conti Pulmonary Injury After Cardiopulmonary Bypass Chest, January 1, 2001; 119(1): 2 - 4. [Full Text] [PDF]
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