Systemic inflammatory response after cardiac surgery: Is extracorporeal circulation the main culprit?

2004 ◽  
pp. 31-47
Author(s):  
J. Börgermann ◽  
I. Friedrich
Keyword(s):  
Cardiac Surgery ◽  
Inflammatory Response ◽  
Extracorporeal Circulation ◽  
Systemic Inflammatory Response ◽  
Main Culprit

Abstract 11053: The Association Between the Systemic Immune-Inflammation Index with the Duration of Cardiopulmonary Bypass in Cardiac Surgery: A Retrospective, Single-Center Study

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Yanan Hu ◽  
Yi Liu ◽  
Yongzhe Liu ◽  
Hui Chen ◽  
Wei Jiang ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Inflammatory Response ◽  
Hospital Stay ◽  
Time Course ◽  
Ischemia Reperfusion ◽  
Systemic Inflammatory Response ◽  
Surgical Trauma ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Immune Inflammation

Introduction: Systemic inflammatory response evoked by cardiac surgery involving a cardio-pulmonary bypass (CPB) in combination of surgical trauma, ischemia/reperfusion injury, hypothermia, and endotoxin release contributed to the postoperative morbidity and mortality. This study aimed to explore the potential of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) as novel markers to evaluate and predict the adverse clinical outcomes after longer CPB time in cardiac surgery. Methods: Patients who underwent cardiac surgery with or without CPB were allocated into two groups, CPB group (n=11) and N-CPB group (n=21). The time course of NLR, PLR, SII, and C-reactive protein (CPR) were analyzed at preoperative day 1 and postoperative day 1, 3, and 7. The baseline and postoperative parameters, the ICU and hospital stay were recorded. Results: There were no differences of baseline parameters between groups. The level of NLR, PLR, SII, and CPR at postoperative day 1 was higher than that in the preoperative day 1 in both groups (p < 0.01). The level of NLR, SII and CPR at postoperative day 3 was higher than that in the preoperative day 1 in both groups (p < 0.05). The NLR and SII at postoperative day 3 were higher in CPB group than that in N-CPB group (p < 0.05). The ICU and hospital stay was longer in CPB group than N-CPB group (p < 0.05). Conclusions: The longer duration of CPB time induced higher systemic inflammatory response characterized by higher level of NLR, PLR and SII. The SII predicted the poor outcome after longer CPB. The peak of systemic inflammatory response occurred on the third day after cardiac surgery.

Systemic inflammatory response in cardiac surgery

2021 ◽  
pp. 94
Author(s):  
L.A. Krichevsky ◽  
V.Yu. Rybakov ◽  
A.A. Dvoryadkin ◽  
D.N. Protsenko
Keyword(s):  
Cardiac Surgery ◽  
Inflammatory Response ◽  
Systemic Inflammatory Response

Modulation of Systemic Inflammatory Response after Cardiac Surgery

2005 ◽  
Vol 13 (4) ◽  
pp. 382-395 ◽  
Author(s):  
Shahzad G Raja ◽  
Gilles D Dreyfus
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Inflammatory Response ◽  
Inflammatory Reaction ◽  
Therapeutic Strategies ◽  
Systemic Inflammatory Response ◽  
Whole Body ◽  
Hemodynamic Stability ◽  
Immunomodulatory Agents ◽  
Considerable Research

Cardiac surgery and cardiopulmonary bypass initiate a systemic inflammatory response largely determined by blood contact with foreign surfaces and the activation of complement. It is generally accepted that cardiopulmonary bypass initiates a whole-body inflammatory reaction. The magnitude of this inflammatory reaction varies, but the persistence of any degree of inflammation may be considered potentially harmful to the cardiac patient. The development of strategies to control the inflammatory response following cardiac surgery is currently the focus of considerable research efforts. Diverse techniques including maintenance of hemodynamic stability, minimization of exposure to cardiopulmonary bypass circuitry, and pharmacologic and immunomodulatory agents have been examined in clinical studies. This article briefly reviews the current concepts of the systemic inflammatory response following cardiac surgery, and the various therapeutic strategies being used to modulate this response.

Modified Criteria for the Systemic Inflammatory Response Syndrome Improves Their Utility Following Cardiac Surgery

CHEST Journal ◽  
2014 ◽  
Vol 145 (6) ◽  
pp. 1197-1203 ◽  
Author(s):  
Niall S. MacCallum ◽  
Simon J. Finney ◽  
Sarah E. Gordon ◽  
Gregory J. Quinlan ◽  
Timothy W. Evans
Keyword(s):  
Cardiac Surgery ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Systemic Inflammatory Response

Role of modified ultrafiltration in reduce of the systemic inflammatory response syndrome in cardiac surgery

2016 ◽  
Vol 7 (1) ◽  
pp. 106-110 ◽  
Author(s):  
Gennadiy G Khubulava ◽  
Sergey P Marchenko ◽  
Ekaterina V Dubova ◽  
Vitaliy V Suvorov
Keyword(s):  
Cardiac Surgery ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Inflammatory Mediators ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Systemic Circulation ◽  
Systemic Inflammatory Response ◽  
Mechanical Removal ◽  
The Moment

During open-heart surgery it is possible to disturbance of the barrier function and the appearance of inflammation in the systemic circulation of inflammatory mediators and pro-inflammatory cytokines, which is realized in the systemic inflammatory response syndrome (SIRS). To prevent the development of the condition, or to reduce the severity of its complications method of mechanical removal of inflammatory mediators and cytokines from the blood of the patient is the most efficient. At the moment, the problem of implementation of the systemic inflammatory response syndrome after surgery using cardiopulmonary bypass quite relevant because of the high frequency of its manifestations and adverse effects [18]. This explains the large number of studies aimed at both the study of the pathogenesis of systemic inflammatory response syndrome and the development of new methods to combat this phenomenon and the improvement of already applied methods and techniques [1, 4]. There are various ways to the reduction of the degree of systemic inflammatory response syndrome, but special attention is given to the study of methods of modified ultrafiltration and continuous veno-venous hemofiltration. Further study of the application of ultrafiltration on patients undergoing cardiac surgery heart surgery with the use of bypass is necessary for understanding of the physiology and pathophysiology of systemic inflammatory response syndrome induced by the conduct of bypass, as well as for the subsequent formulation of clinical guidelines for use in cardiac surgery practice. In this article we have tried to consider the most significant results of such studies.

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