|
|
||||||||
Eur J Cardiothorac Surg 2002;21:232-244
© 2002 Elsevier Science NL
Review |
a Division of Cardiovascular Surgery, Toronto General Hospital, University of Toronto, Eaton North 13-222, 200 Elizabeth Street, Toronto, Ontario, Canada M5G 2C4
b Department of Pathology and Molecular Medicine, McMaster University, Hamilton Civic Hospital Research Centre, Hamilton, Ontario, Canada
Received 29 March 2001; received in revised form 27 August 2001; accepted 12 November 2001.
* Corresponding author. Tel.: +1-416-340-3451; fax: +1-416-340-3803
e-mail: paparella{at}tin.it
Cardiac surgery with cardiopulmonary bypass (CPB) induces an acute phase reaction that has been implicated in the pathogenesis of several postoperative complications. Recent data indicate that a complex sequence of events leads to the final activation of leukocytes and endothelial cells (EC), which is responsible for cell dysfunction in different organs. Activation of the contact system, endotoxemia, ischemia and reperfusion injury and surgical trauma are all potential triggers of inflammation following CPB. Different pro- and anti-inflammatory mediators (cytokines, adhesion molecules) are involved and their release is mediated by intracellular transcription factors (nuclear factor-kB, NF-kB). In this review, we examine recent advances in the understanding of the pathophysiology of the CPB-induced acute phase reaction and evaluate the different pharmacological, technical and surgical strategies used to reduce its effects. Emphasis is given to the central role of transcription factor NF-kB in the complex mechanism of the inflammatory reaction and to the effects of compounds such as heparin and glycosaminoglycans, phosphodiesterase inhibitors and protease inhibitors whose role as anti-inflammatory agent has only recently been recognized.
Key Words: Cardiopulmonary bypass Inflammation Acute phase reaction Nuclear factor-kB Cytokine Heparin
This article has been cited by other articles:
![]() |
Z. Shen, Z. Wang, J. Zhang, and H. Jing Hepatic injury in a rat cardiopulmonary bypass model Interactive CardioVascular and Thoracic Surgery, February 1, 2008; 7(1): 18 - 22. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. H. Rosner, D. Portilla, and M. D. Okusa Analytic Reviews: Cardiac Surgery as a Cause of Acute Kidney Injury: Pathogenesis and Potential Therapies J Intensive Care Med, January 1, 2008; 23(1): 3 - 18. [Abstract] [PDF] |
||||
![]() |
J. W. Hammon Extracorporeal Circulation: The Response of Humoral and Cellular Elements of Blood to Extracorporeal Circulation Card. Surg. Adult, January 1, 2008; 3(2008): 370 - 389. [Full Text] |
||||
![]() |
F. de Lange, K. Yoshitani, A. D. Proia, G. B. Mackensen, and H. P. Grocott Perfluorocarbon Administration During Cardiopulmonary Bypass in Rats: An Inflammatory Link to Adverse Outcome? Anesth. Analg., January 1, 2008; 106(1): 24 - 31. [Abstract] [Full Text] [PDF] |
||||
![]() |
Y. Orr, J. M. Taylor, S. Cartland, P. G. Bannon, C. Geczy, and L. Kritharides Conformational activation of CD11b without shedding of L-selectin on circulating human neutrophils J. Leukoc. Biol., November 1, 2007; 82(5): 1115 - 1125. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Rehm, D. Bruegger, F. Christ, P. Conzen, M. Thiel, M. Jacob, D. Chappell, M. Stoeckelhuber, U. Welsch, B. Reichart, et al. Shedding of the Endothelial Glycocalyx in Patients Undergoing Major Vascular Surgery With Global and Regional Ischemia Circulation, October 23, 2007; 116(17): 1896 - 1906. [Abstract] [Full Text] [PDF] |
||||
![]() |
B. Ramlawi, H. Otu, J. L. Rudolph, S. Mieno, I. S. Kohane, H. Can, T. A. Libermann, E. R. Marcantonio, C. Bianchi, and F. W. Sellke Genomic expression pathways associated with brain injury after cardiopulmonary bypass. J. Thorac. Cardiovasc. Surg., October 1, 2007; 134(4): 996 - 1005.e4. [Abstract] [Full Text] [PDF] |
||||
![]() |
O. J. Liakopoulos, J. D. Schmitto, S. Kazmaier, A. Brauer, M. Quintel, F. A. Schoendube, and H. Dorge Cardiopulmonary and Systemic Effects of Methylprednisolone in Patients Undergoing Cardiac Surgery Ann. Thorac. Surg., July 1, 2007; 84(1): 110 - 119. [Abstract] [Full Text] [PDF] |
||||
![]() |
Y. An, Y.-B. Xiao, and Q.-J. Zhong Open-heart surgery in patients with liver cirrhosis Eur. J. Cardiothorac. Surg., June 1, 2007; 31(6): 1094 - 1098. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Chello, A. Anselmi, C. Spadaccio, G. Patti, C. Goffredo, G. Di Sciascio, and E. Covino Simvastatin Increases Neutrophil Apoptosis and Reduces Inflammatory Reaction After Coronary Surgery Ann. Thorac. Surg., April 1, 2007; 83(4): 1374 - 1380. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. R. Stier and E. W. Verde The postoperative care of adult patients exposed to deep hypothermic circulatory arrest. Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2007; 11(1): 77 - 85. [Abstract] [PDF] |
||||
![]() |
I. Massad, H. Abu-Ali, C. Biron-Andreani, M.-C. Picot, and P. trinh-Duc Antithrombin and Protein C in Systemic Inflammatory Response Syndrome Asian Cardiovasc Thorac Ann, February 1, 2007; 15(1): 39 - 44. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. Cappabianca, D. Paparella, G. Visicchio, G. Capone, G. Lionetti, F. Numis, P. Ferrara, C. D'Agostino, and L. de Luca Tupputi Schinosa Preoperative C-Reactive Protein Predicts Mid-Term Outcome After Cardiac Surgery Ann. Thorac. Surg., December 1, 2006; 82(6): 2170 - 2178. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. R. Hoda, H. El-Achkar, E. Schmitz, T. Scheffold, H. O. Vetter, and R. De Simone Systemic Stress Hormone Response in Patients Undergoing Open Heart Surgery With or Without Cardiopulmonary Bypass Ann. Thorac. Surg., December 1, 2006; 82(6): 2179 - 2186. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. E. Asberg and V. Videm Neutrophil dysfunction after biomaterial contact in an in vitro model of cardiopulmonary bypass Eur. J. Cardiothorac. Surg., November 1, 2006; 30(5): 744 - 748. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. Machin and C. Allsager Principles of cardiopulmonary bypass CEACCP, October 1, 2006; 6(5): 176 - 181. [Full Text] [PDF] |
||||
![]() |
V. von Dossow, N. Baehr, M. Moshirzadeh, C. von Heymann, J. P. Braun, O. V. Hein, M. Sander, K.-D Wernecke, W. Konertz, and C. D. Spies Clonidine Attenuated Early Proinflammatory Response in T-Cell Subsets After Cardiac Surgery Anesth. Analg., October 1, 2006; 103(4): 809 - 814. [Abstract] [Full Text] [PDF] |
||||
![]() |
O. J. Liakopoulos, N. Teucher, C. Muhlfeld, P. Middel, G. Heusch, F. A. Schoendube, and H. Dorge Prevention of TNFalpha-associated myocardial dysfunction resulting from cardiopulmonary bypass and cardioplegic arrest by glucocorticoid treatment. Eur. J. Cardiothorac. Surg., August 1, 2006; 30(2): 263 - 270. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. A. Skrabal, Y. H. Choi, A. Kaminski, M. Steiner, G. Kundt, G. Steinhoff, and A. Liebold Circulating endothelial cells demonstrate an attenuation of endothelial damage by minimizing the extracorporeal circulation. J. Thorac. Cardiovasc. Surg., August 1, 2006; 132(2): 291 - 296. [Abstract] [Full Text] [PDF] |
||||
![]() |
H. Riha, J. A. Hubacek, R. Poledne, P. Kellovsky, A. Brezina, and J. Pirk IL-10 and TNF-beta gene polymorphisms have no major influence on lactate levels after cardiac surgery. Eur. J. Cardiothorac. Surg., July 1, 2006; 30(1): 54 - 58. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Westerberg, J. Gabel, A. Bengtsson, J. Sellgren, O. Eidem, and A. Jeppsson Hemodynamic effects of cardiotomy suction blood J. Thorac. Cardiovasc. Surg., June 1, 2006; 131(6): 1352 - 1357. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. Simonardottir, B. Torfason, E. Stefansson, and J. Magnusson Changes in muscle compartment pressure after cardiopulmonary bypass Perfusion, May 1, 2006; 21(3): 157 - 163. [Abstract] [PDF] |
||||
![]() |
K. Karkouti, S. Shayan, D. N. Wijeysundera, S. A. McCluskey, M. Ghannam, and W. S. Beattie Prognostic value of postoperative proteinuria in cardiac surgery: a pilot study: [Valeur pronostique de la proteinurie postoperatoire en chirurgie cardiaque : une etude pilote]. Can J Anesth, May 1, 2006; 53(5): 500 - 506. [Abstract] [Full Text] [PDF] |
||||
![]() |
F.-X. Schmid, N. Vudattu, B. Floerchinger, M. Hilker, G. Eissner, M. Hoenicka, E. Holler, and D. E. Birnbaum Endothelial apoptosis and circulating endothelial cells after bypass grafting with and without cardiopulmonary bypass. Eur. J. Cardiothorac. Surg., April 1, 2006; 29(4): 496 - 500. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. Paparella, A. Galeone, M. T. Venneri, M. Coviello, G. Scrascia, N. Marraudino, M. Quaranta, L. de Luca Tupputi Schinosa, and S. J. Brister Activation of the coagulation system during coronary artery bypass grafting: Comparison between on-pump and off-pump techniques J. Thorac. Cardiovasc. Surg., February 1, 2006; 131(2): 290 - 297. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. H. Rosner and M. D. Okusa Acute Kidney Injury Associated with Cardiac Surgery Clin. J. Am. Soc. Nephrol., January 1, 2006; 1(1): 19 - 32. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. Reis Miranda, D. Gommers, A. Struijs, R. Dekker, J. Mekel, R. Feelders, B. Lachmann, and A. J.J.C. Bogers Ventilation according to the open lung concept attenuates pulmonary inflammatory response in cardiac surgery Eur. J. Cardiothorac. Surg., December 1, 2005; 28(6): 889 - 895. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Lund, K. Sundet, B. Tennoe, P. K. Hol, K. A. Rein, E. Fosse, and D. Russell Cerebral Ischemic Injury and Cognitive Impairment After Off-Pump and On-Pump Coronary Artery Bypass Grafting Surgery Ann. Thorac. Surg., December 1, 2005; 80(6): 2126 - 2131. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. M. Morariu, B. G. Loef, L. P. H. J. Aarts, G. W. Rietman, G. Rakhorst, W. van Oeveren, and A. H. Epema Dexamethasone: Benefit and Prejudice for Patients Undergoing On-Pump Coronary Artery Bypass Grafting: A Study on Myocardial, Pulmonary, Renal, Intestinal, and Hepatic Injury Chest, October 1, 2005; 128(4): 2677 - 2687. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Koster, W. Bottcher, F. Merkel, R. Hetzer, and H. Kuppe The more closed the bypass system the better: a pilot study on the effects of reduction of cardiotomy suction and passive venting on hemostatic activation during on-pump coronary artery bypass grafting Perfusion, September 1, 2005; 20(5): 285 - 288. [Abstract] [PDF] |
||||
![]() |
J. Seeburger, J. Hoffmann, H. P. Wendel, G. Ziemer, and H. Aebert Gene Expression Changes in Leukocytes During Cardiopulmonary Bypass Are Dependent on Circuit Coating Circulation, August 30, 2005; 112(9_suppl): I-224 - I-228. [Abstract] [Full Text] [PDF] |
||||
![]() |
E. Zupancich, D. Paparella, F. Turani, C. Munch, A. Rossi, S. Massaccesi, and V. M. Ranieri Mechanical ventilation affects inflammatory mediators in patients undergoing cardiopulmonary bypass for cardiac surgery: A randomized clinical trial J. Thorac. Cardiovasc. Surg., August 1, 2005; 130(2): 378 - 383. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. Gerrah, A. Elami, A. Stamler, A. Smirnov, and Z. Stoeger Preoperative Aspirin Administration Improves Oxygenation in Patients Undergoing Coronary Artery Bypass Grafting Chest, May 1, 2005; 127(5): 1622 - 1626. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. W. Staton, W. H. Williams, E. M. Mahoney, J. Hu, H. Chu, P. G. Duke, and J. D. Puskas Pulmonary Outcomes of Off-Pump vs On-Pump Coronary Artery Bypass Surgery in a Randomized Trial Chest, March 1, 2005; 127(3): 892 - 901. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. D. Rubens, H. Nathan, R. Labow, K. S. Williams, D. Wozny, J. Karsh, M. Ruel, and T. Mesana Effects of Methylprednisolone and a Biocompatible Copolymer Circuit on Blood Activation During Cardiopulmonary Bypass Ann. Thorac. Surg., February 1, 2005; 79(2): 655 - 665. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. J Murphy, R. Ascione, and G. D Angelini Coronary artery bypass grafting on the beating heart: surgical revascularization for the next decade? Eur. Heart J., December 1, 2004; 25(23): 2077 - 2085. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. Lindholm, M. Westerberg, A. Bengtsson, R. Ekroth, E. Jensen, and A. Jeppsson A Closed Perfusion System With Heparin Coating and Centrifugal Pump Improves Cardiopulmonary Bypass Biocompatibility in Elderly Patients Ann. Thorac. Surg., December 1, 2004; 78(6): 2131 - 2138. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. C. Harmon, K. G. Ghori, N. P. Eustace, S. J. F. O'Callaghan, A. P. O'Donnell, and G. D. Shorten Aprotinin decreases the incidence of cognitive deficit following CABG and cardiopulmonary bypass: a pilot randomized controlled study: [L'aprotinine reduit l'incidence de deficit cognitif a la suite d'un PAC et de la circulation extracorporelle : une etude pilote randomisee et controlee] Can J Anesth, December 1, 2004; 51(10): 1002 - 1009. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. van den Goor, R. Nieuwland, A. van den Brink, W. van Oeveren, P. Rutten, J. Tijssen, and L. Eijsman Reduced complement activation during cardiopulmonary bypass does not affect the postoperative acute phase response Eur. J. Cardiothorac. Surg., November 1, 2004; 26(5): 926 - 931. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. Cohen, A. Kogan, G. Sahar, S. Lev, B. Vidne, and P. Singer Hypophosphatemia following open heart surgery: incidence and consequences Eur. J. Cardiothorac. Surg., August 1, 2004; 26(2): 306 - 310. [Abstract] [Full Text] [PDF] |
||||
![]() |
K. H. T. Teoh, E. Young, M. H. Blackall, R. S. Roberts, and J. Hirsh Can extra protamine eliminate heparin rebound following cardiopulmonary bypass surgery? J. Thorac. Cardiovasc. Surg., August 1, 2004; 128(2): 211 - 219. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Westerberg, A. Bengtsson, and A. Jeppsson Coronary surgery without cardiotomy suction and autotransfusion reduces the postoperative systemic inflammatory response Ann. Thorac. Surg., July 1, 2004; 78(1): 54 - 59. [Abstract] [Full Text] [PDF] |
||||
![]() |
I. Y. P. Wan, A. A. Arifi, S. Wan, J. H. Y. Yip, A. D. L. Sihoe, K.H. Thung, E. M. C. Wong, and A. P. C. Yim Beating heart revascularization with or without cardiopulmonary bypass: Evaluation of inflammatory response in a prospective randomized study J. Thorac. Cardiovasc. Surg., June 1, 2004; 127(6): 1624 - 1631. [Abstract] [Full Text] [PDF] |
||||
![]() |
T. Ikuta, H. Fujii, T. Shibata, K. Hattori, H. Hirai, H. Kumano, and S. Suehiro A new poly-2-methoxyethylacrylate-coated cardiopulmonary bypass circuit possesses superior platelet preservation and inflammatory suppression efficacy Ann. Thorac. Surg., May 1, 2004; 77(5): 1678 - 1683. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Verma, P. W.M. Fedak, R. D. Weisel, P. E. Szmitko, M. V. Badiwala, D. Bonneau, D. Latter, L. Errett, and Y. LeClerc Off-Pump Coronary Artery Bypass Surgery: Fundamentals for the Clinical Cardiologist Circulation, March 16, 2004; 109(10): 1206 - 1211. [Full Text] [PDF] |
||||
![]() |
A. Anselmi, A. Abbate, F. Girola, G. Nasso, G. G.L. Biondi-Zoccai, G. Possati, and M. Gaudino Myocardial ischemia, stunning, inflammation, and apoptosis during cardiac surgery: a review of evidence Eur. J. Cardiothorac. Surg., March 1, 2004; 25(3): 304 - 311. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Koster, S. Huebler, F. Merkle, T. Hentschel, M. Grundel, T. Krabatsch, L. Tambeur, M. Praus, H. Habazettl, W. M. Kuebler, et al. Heparin-Level-Based Anticoagulation Management During Cardiopulmonary Bypass: A Pilot Investigation on the Effects of a Half-Dose Aprotinin Protocol on Postoperative Blood Loss and Hemostatic Activation and Inflammatory Response Anesth. Analg., February 1, 2004; 98(2): 285 - 290. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. Philippidis, J.C. Mason, B.J. Evans, I. Nadra, K.M. Taylor, D.O. Haskard, and R.C. Landis Hemoglobin Scavenger Receptor CD163 Mediates Interleukin-10 Release and Heme Oxygenase-1 Synthesis: Antiinflammatory Monocyte-Macrophage Responses In Vitro, in Resolving Skin Blisters In Vivo, and After Cardiopulmonary Bypass Surgery Circ. Res., January 9, 2004; 94(1): 119 - 126. [Abstract] [Full Text] [PDF] |
||||
![]() |
L. Wehlin, J. Vedin, J. Vaage, and J. Lundahl Activation of complement and leukocyte receptors during on- and off pump coronary artery bypass surgery Eur. J. Cardiothorac. Surg., January 1, 2004; 25(1): 35 - 42. [Abstract] [Full Text] [PDF] |
||||
![]() |
H. Eikemo, O. F. M. Sellevold, and V. Videm Markers for endothelial activation during open heart surgery Ann. Thorac. Surg., January 1, 2004; 77(1): 214 - 219. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. H Olivencia-Yurvati, N. Wallace, S. Ford, and R. T Mallet Leukocyte filtration and aprotinin: synergistic anti-inflammatory protection Perfusion, January 1, 2004; 19(1_suppl): S13 - S19. [Abstract] [PDF] |
||||
![]() |
R. J. Scheubel, H. Zorn, R.-E. Silber, O. Kuss, H. Morawietz, J. Holtz, and A. Simm Age-dependent depression in circulating endothelial progenitor cells inpatients undergoing coronary artery bypass grafting J. Am. Coll. Cardiol., December 17, 2003; 42(12): 2073 - 2080. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. L. Ngaage Off-pump coronary artery bypass grafting: the myth, the logic and the science Eur. J. Cardiothorac. Surg., October 1, 2003; 24(4): 557 - 570. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Lund, P. K. Hol, R. Lundblad, E. Fosse, K. Sundet, B. Tennoe, R. Brucher, and D. Russell Comparison of cerebral embolization during off-pump and on-pump coronary artery bypass surgery Ann. Thorac. Surg., September 1, 2003; 76(3): 765 - 770. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. Gessler, J. Pfenninger, J.-P. Pfammatter, T. Carrel, O. Baenziger, and C. Dahinden Plasma levels of interleukin-8 and expression of interleukin-8 receptors on circulating neutrophils and monocytes after cardiopulmonary bypass in children J. Thorac. Cardiovasc. Surg., September 1, 2003; 126(3): 718 - 725. [Abstract] [Full Text] [PDF] |
||||
![]() |
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] |
||||
![]() |
D. Harmon, E. Coleman, C. Marshall, W. Lan, and G. Shorten The Effect of Clomethiazole on Plasma Concentrations of Interleukin-6, -8, -1{beta}, Tumor Necrosis Factor-{alpha}, and Neutrophil Adhesion Molecule Expression During Experimental Extracorporeal Circulation Anesth. Analg., July 1, 2003; 97(1): 13 - 18. [Abstract] [Full Text] [PDF] |
||||
![]() |
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] |