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Ann Thorac Surg 1995;60:1740
© 1995 The Society of Thoracic Surgeons

Invited Commentary

Invited Commentary

Robert E. Helm, MD

Cardiothoracic Surgery Research Laboratory, Rm A-827, Department of Cardiothoracic Surgery, New York Hospital-Cornell Medical Center, 525 E 68th St, Box 378, New York, NY 10021

The first 20% of the full text of this article appears below.

See also page 1735.

Emphasis on the hematologic effects of cardiopulmonary bypass (CPB) has traditionally been placed on platelets, white cells, and the various inflammatory cascades, but it should not be forgotten that the major component of blood is the red cell. Typically during and immediately after CPB one quarter to one third of a patient's red cell mass is lost, even with maximum intraoperative and postoperative salvage efforts. A significant portion of this loss occurs during CPB, as a result of foreign surface shear stresses, interaction with complement and other mediators of the inflammatory response, and direct mechanical trauma from connectors, tubing bifurcations, occlusive pumps, and cell salvage apparatus. Red cells contain the body's largest pool of iron in the form of hemoglobin, as well as antioxidant power in the form of glutathione. These red cell constituents are released into plasma when red cells are damaged or destroyed during cardiopulmonary bypass. What are the consequences of this release? Applying . . . [Full Text of this Article]


Related Article

Blood Cardioplegia Increases Plasma Iron Overload and Thiol Levels During Cardiopulmonary Bypass
John R. Pepper, Sharon Mumby, and John M. C. Gutteridge
Ann. Thorac. Surg. 1995 60: 1735-1740. [Abstract] [Full Text]





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