Endotoxin release in cardiac surgery with cardiopulmonary bypass: pathophysiology and possible therapeutic strategies. An update.

Autor: Kats S; Department of Cardio-Thoracic Surgery, Catharina Hospital Eindhoven, Michelangelolaan 2, 5602 ZA Eindhoven, The Netherlands. skats@chello.nl, Schönberger JP, Brands R, Seinen W, van Oeveren W
Jazyk: angličtina
Zdroj: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery [Eur J Cardiothorac Surg] 2011 Apr; Vol. 39 (4), pp. 451-8.
DOI: 10.1016/j.ejcts.2010.06.011
Abstrakt: Cardiac surgery with cardiopulmonary bypass provokes a systemic inflammatory response syndrome caused by the surgical trauma itself, blood contact with the non-physiological surfaces of the extracorporeal circuit, endotoxemia, and ischemia. The role of endotoxin in the inflammatory response syndrome has been well investigated. In this report, we reviewed recent advances in the understanding of the pathophysiology of the endotoxin release during cardiopulmonary bypass and the possible therapeutic strategies aimed to reduce the endotoxin release or to counteract the inflammatory effects of endotoxin. Although many different strategies to detoxify endotoxins were evaluated, none of them were able to show statistically significant differences in clinical outcome.
(Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE