The systemic complications of cardiopulmonary bypass
| Autor: | R.S. Bonser, S.M. Allen |
|---|---|
| Rok vydání: | 1993 |
| Předmět: |
medicine.medical_specialty
education.field_of_study business.industry Population Blood flow Critical Care and Intensive Care Medicine Extracorporeal Pathophysiology Cardiac surgery law.invention surgical procedures operative Anesthesiology and Pain Medicine law Interstitial fluid Internal medicine medicine Cardiopulmonary bypass Cardiology Platelet education business circulatory and respiratory physiology |
| Zdroj: | Current Anaesthesia & Critical Care. 4:135-140 |
| ISSN: | 0953-7112 |
| Popis: | Over 500 patients per million population per annum require cardiopulmonary bypass (CPB) to support the circulation during cardiac surgery. Steady improvements in technique have made CPB increasingly safer, but because of the artificial environment of the extracorporeal circuit it can never be truly physiological; the normal functions of blood flow, gas exchange, blood surface interface effects and the reticuloendothelial system are replaced in total or in part by the extracorporeal circuit. Subsequent changes in individual organ function are secondary to these substitutions and major pathophysiological changes have been observed clinically, including coagulopathies and profound disturbances of cardiac, pulmonary, renal and cerebral function. Although most patients will convalesce normally nearly all of them show evidence of some damage related to CPB, manifested as anaemia, platelet damage, peripheral vasoconstriction and evidence of a systemic inflammatory response characterised by fever, increased capillary permeability, increased interstitial fluid and leucocytosis.’ This review is divided into a number of parts. Firstly, a brief account discusses the physiological changes that occur in conventional CPB. Secondly, the damaging systemic effects of CPB are described. Following this, the effects of these changes upon individual organ function following CPB will be outlined. Finally methods of attenuating the damage associated with CPB will be reviewed. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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