Key Points for Curbing Cardiopulmonary Bypass Inflammation

Évora, Paulo Roberto Barbosa; Bottura, C; Arcêncio, Livia; Albuquerque, Agnes Afrodite Sumarelli; Évora, Patricia Martinez; Rodrigues, Alfredo José

doi:10.1590/s0102-86502016001300010

Cited by 32 publications

(25 citation statements)

References 22 publications

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“…Isolation of leukocyte is affected by the duration of the aortic and CPB mutual clamping. It is believed that this is one of the major causes of pulmonary damage after onpump surgery [49][50][51]. Several studies have been carried out to illustrate the effects of the pump on PC.…”

Section: Cardiopulmonary Bypass Pumpmentioning

confidence: 99%

Pulmonary complications following cardiac surgery

Mali¹,

Haghaninejad²

2019

Arch Med Sci Atheroscler Dis

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Coronary heart disease is a common diseases of atherosclerosis. Despite the development of noninvasive therapies and the advancement of pharmacological methods and extensive drug regimens, coronary artery bypass grafting surgery is still the ultimate treatment option in many patients. Among the various complications following open heart surgery, one of the common difficulties is pulmonary complications associated with subsequent morbidity and mortality, which should be studied according to preoperative, perioperative, and postoperative factors. Preoperative factors include genetics, age, family history of pulmonary disease, smoking, coexisting disease, etc. Perioperative factors include surgical procedures like sternotomy incision, cardioplegia, and internal mammary artery harvesting; anaesthesia procedure effects like pulmonary collapse, maintenance drugs and morphine administration; and cardiopulmonary bypass pump by systemic inflammatory response syndromes. And finally, postoperative factors, especially mediastinitis and the role of nursing in the intensive care unit. Pulmonary complications after cardiac surgery include atelectasis, pleural effusions, pneumonia, pulmonary oedema, cardiogenic pulmonary oedema, acute respiratory distress syndrome, pulmonary embolism, phrenic nerve injury, pneumothorax, sternal wound infection, and mediastinitis, with different outbreaks in patients reported. Although the preoperative, perioperative, and postoperative factors play an important role in the occurrence of these complications, the preoperative factors, as factors that can be adjusted, should be considered more than the others and explained to the patient, and the preoperative patient's assessment should be noted. Also, postoperative care with the goal of reducing infections and pulmonary complications should be addressed by the nursing team.

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Section: Cardiopulmonary Bypass Pumpmentioning

confidence: 99%

Pulmonary complications following cardiac surgery

Mali¹,

Haghaninejad²

2019

Arch Med Sci Atheroscler Dis

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“…This hypothesis proposes that blood coming into contact with serous membranes (pleura and pericardium) causes fibrinolytic activity and increases bleeding, which agrees with recent advances in our knowledge and understanding about the association between coagulation and inflammation. As coagulation management during CPB is one of the most serious problems, it is possible that inadequate heparin use could handle inappropriate, imperceptible anticoagulation and therefore also trigger inflammation [4,5] . Thus, maintenance of pleural integrity in the dissection of internal thoracic arteries should be an interesting detail of the surgical technique.…”

Section: Is the Cardiopulmonary Bypass Systemic Inflammatory Responsementioning

confidence: 99%

Is the Cardiopulmonary Bypass Systemic Inflammatory Response Overestimated?

Évora¹,

Tenório²,

Braile³

2018

Braz J Cardiovasc Surg

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“…Zwei Studien an Patienten mit respiratorischem Versagen (EDEN Trial [60] und Rice et al [72]) zeigten sogar keinen Unterschied bezüglich Mortalität zwischen voller Ernährung (70-100 %) und "trophischer Ernährung" (10 ml Ernährung pro Stunde entsprechend 10-20 kcal/h = 16 % des errechneten Tagesbedarfs). In 2 prospektiven Studien der Arbeitsgruppen um Heyland [7,13,20,27,34].…”

Section: Menge Und Zusammensetzung Der Ernährungunclassified

Die Rolle der Ernährung beim herzchirurgischen Patienten – eine Übersicht

Hill¹,

Goetzenich²,

Marx³

et al. 2018

Anästhesiol Intensivmed Notfallmed Schmerzther

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Cardiac surgery patients regularly experience a systemic inflammation response to the surgery and a postoperative stay in the intensive care unit. Nutritional support is one strategy to improve the outcome of cardiosurgical patients. A preoperatively diagnosed malnutrition contributes to a higher morbidity and mortality in this patient group. Preoperative fasting, glucose-free infusions during long and invasive operations and delayed postoperative nutrition therapy aggravate the nutrition situation. However, conclusive evidence for this population, consisting of well-conducted clinical trials is lacking.This article outlines the main causes for malnutrition in cardiosurgical patients and summarizes possibilities to identify patients at high nutritional risk, who are most likely to profit from aggressive nutritional therapy. Despite conspicuous knowledge and evidence gaps, a rational nutritional support therapy based on current recommendations of ASPEN, ESPEN and an international multidisciplinary consensus group is presented. The amount and kind of nutrition, as well as the best time to initiate nutrition support, ways to monitor nutrition therapy and the potential use of pharmaconutrition to modulate the inflammatory response to cardiopulmonary bypass are presented to benefit patients undergoing cardiac surgery.

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Key Points for Curbing Cardiopulmonary Bypass Inflammation

Cited by 32 publications

References 22 publications

Pulmonary complications following cardiac surgery

Pulmonary complications following cardiac surgery

Is the Cardiopulmonary Bypass Systemic Inflammatory Response Overestimated?

Die Rolle der Ernährung beim herzchirurgischen Patienten – eine Übersicht

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