Organ dysfunction after cardiopulmonary bypass. A systemic inflammatory reaction initiated by the extracorporeal circuit

1987 ◽  
Vol 13 (2) ◽  
Author(s):  
S. Westaby
Keyword(s):  
Cardiopulmonary Bypass ◽  
Organ Dysfunction ◽  
Inflammatory Reaction ◽  
Extracorporeal Circuit ◽  
Systemic Inflammatory Reaction

scholarly journals Perioperative Vitamin C and E levels in Cardiac Surgery Patients and Their Clinical Significance

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2157
Author(s):  
Aileen Hill ◽  
Christina Borgs ◽  
Christina Fitzner ◽  
Christian Stoppe
Keyword(s):  
Oxidative Stress ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Vitamin E ◽  
Vitamin C ◽  
Observational Study ◽  
Clinical Significance ◽  
Organ Dysfunction ◽  
Inflammatory Reaction ◽  
Primary Objective

Background: Oxidative stress contributes to organ dysfunction after cardiac surgery and still represents a major problem. Antioxidants, such as vitamins C and E might be organ protective. Methods: The primary objective of this prospective observational study was the description to evaluate the perioperative vitamin C and E levels in 56 patients undergoing cardiac surgery with the use of cardiopulmonary bypass. The association of vitamin C with inflammatory reaction, oxidative stress, organ dysfunctions, and clinical outcomes were evaluated in an explorative approach. Results: Vitamin C levels decreased significantly from 6.5 (3.5–11.5) mg/L before surgery to 2.8 (2.0–3.9) mg/L 48 h after surgery (p < 0.0001). Fifty-six percent of patients had a suboptimal vitamin C status even before surgery. In protein-denaturized probes, significantly higher vitamin C concentrations were detected (p = 0.0008). Vitamin E levels decreased significantly from preoperative level 11.6 (9.5–13.2) mg/L to 7.1 (5.5–7.4) mg/L, (p = 0.0002) at the end of cardiopulmonary bypass, remained low during the first day on ICU and recovered to 8.2 (7.1–9.3) mg/L 48 h after surgery. No patient was vitamin E deficient before surgery. Analysis showed no statistically significant association of vitamin C with inflammation, oxidative stress or organ dysfunction levels in patients with previously suboptimal vitamin C status or patients with a perioperative decrease of ≥50% vitamin C after surgery. Patients with higher vitamin C levels had a shorter ICU stay than those who were vitamin C depleted, which was not statistically significant (72 versus 135 h, p = 0.1990). Conclusion: Vitamin C and E levels significantly declined intraoperatively and remained significantly reduced low for 2 days after cardiac surgery. The influence of reduced serum levels on the inflammatory reaction and clinical outcome of the patients remain unclear in this small observational study and need to be investigated further. Given vitamin C´s pleiotropic role in the human defense mechanisms, further trials are encouraged to evaluate the clinical significance of Vitamin C in cardiac surgery patients.

scholarly journals SUBMICROSCOPIC CHANGES OF BRITTLE CELLS IN THE FORMATION OF SYNDROME OF SYSTEMIC INFLAMMATORY REACTION

2017 ◽  
Vol 16 (4) ◽  
pp. 9-12
Author(s):  
V. V. Boiko ◽  
P. N. Zamiatyn ◽  
Yu. N. Solovei ◽  
A. Y. Trubchanyn ◽  
V. P. Nevzorov ◽  
...  
Keyword(s):  
Inflammatory Reaction ◽  
Systemic Inflammatory Reaction

scholarly journals DISTURBANCE OF AN APOPTOSIS OF NEUTROPHILS AT A SEPSIS

2018 ◽  
Vol 8 (2) ◽  
pp. 119-126 ◽  
Author(s):  
X.-F. Shen ◽  
W.-X. Guan ◽  
J.-F. Du ◽  
L. V. Puzyryova
Keyword(s):  
Inflammatory Reaction ◽  
Infectious Agent ◽  
Natural Conditions ◽  
Systemic Inflammatory Reaction ◽  
Programmed Death ◽  
Peking University ◽  
Cellular Apoptosis ◽  
A Cell ◽  
And Migration ◽  
A Current

The sepsis represents life-endangering disturbances of functions of the internals caused by a dizregulyation of a macroorganism to the  infectious agent and is difficult interaction of pro-inflammatory and  antiinflammatory processes that not seldom defines the fate of  patients. The predetermining factor of a sepsis is the originator. The  immunosupression caused by the originator promotes generalization  of an infection, and the intensive bacteriemia caused by generalization leads to the accruing endotoxinemia that aggravates  immunosupression even more and leads finally to systemic inflammatory reaction — the main and most dangerous implication  of a sepsis. The syndrome of systemic inflammation with  uncontrollable emission of cytokines is the cornerstone of a sepsis.  The pathophysiology of a sepsis begins with impassioned inflammatory reaction which can last several days, and then passes  into more lingering immunosupressivny period where the outcome  depends on the immune system of the patient. Cellular apoptosis is  one of leaders in sepsis immunosupression development. In article  mechanisms of disturbance of an apoptosis of neutrophils are  described that, undoubtedly, affects weighting of a current of a  sepsis and as a result, a failure. Migration of neutrophils under  natural conditions includes four various phases which during a sepsis  are broken. The mechanisms worsening migration of  neutrophils, contributing to the development of a sepsis were  investigated in numerous scientific works. Authors of Peking  University offered schemes of a way of disturbance of an apoptosis  of neutrophils and migration of neutrophils at a sepsis. Despite the  extensive accumulated experience on studying of a pathogenesis of  septic states, there are no effective and specific remedies of fight  from a sepsis now. Perhaps, by prevention of disturbance of the  programmed death of a cell the cytokines developed anti-apoptotic,  caspase inhibitors will be. 

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.

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