Ventilation during Cardiopulmonary Bypass: Impact on Neutrophil Activation and Pulmonary Sequestration

Abstract

Cardiopulmonary bypass during coronary artery bypass grafting is associated with increased neutrophil pulmonary sequestration, and blood neutrophil CD11b activation. Continuous ventilation during cardiopulmonary bypass does not significantly reduce neutrophil pulmonary sequestration or activation.

Independent Risk Factors for Ventilator-Associated Pneumonia After Cardiac Surgery

“…Tracheal intubation or tracheostomyrelated injury leads to the damage of normal physiological barrier function of the airway mucosa damage, so that gas directly gets into the alveoli by bronchoalveolar, and this increases the occurrence of infection [10][11][12]. Applications designed to reduce the duration of mechanical ventilation, the rates of reintubation, or increase the use of noninvasive ventilation (NIV) strategy may reduce the incidence of VAP [13].…”

Pulmonary complications of cardiopulmonary bypass

“…Oxygenation will only occur through passive diffusion as the pulmonary vasculature is excluded during CPB. Various regimens of ventilatory settings (i.e., intermittent, continuous, CPAP, low tidal volume, and positive end-expiratory pressure (PEEP)) have been studied, during and after separation from CPB, with mixed results in regard to inflammatory markers as well as to clinical outcomes [99] , ∗[100] , [101] . Ventilation during CPB might not always be feasible as the inflated lung could interfere with surgical exposure.…”

Lung ischaemia–reperfusion induced gene expression

“…Cardiac surgery and thoracic organ transplantation patients undergoing intermittent lung ventilation or pulmonary perfusion are most at risk of lung IR injury [2,3]. Furthermore, mechanical ventilation may cause additional lung injury [4,5], or under the appropriate conditions, attenuate pulmonary inflammation [6,7]. Pulmonary necrosis, and more recently, apoptosis have been found to be important processes in the development of IRinduced pulmonary dysfunction [2].…”