2006, Number S2
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Arch Cardiol Mex 2006; 76 (S2)
Systemic inflammatory response in pediatric cardiac surgery
Lespron RMC
Language: Spanish
References: 20
Page: 92-99
PDF size: 110.20 Kb.
ABSTRACT
Systemic Inflammatory Response (SIR) constitutes
generalized, non- specific response to tissue
injury of whatever etiology, and is a rapid,
highly amplified, controlled humeral and cellular
response. Cardiopulmonary Bypass (CPB)
is necessary in many cardiac surgery as in adults
as children. Also we know the undesirable effects
of SIR. The pediatric surgical team to treat
of management very well if exist the threat of
undesirable outcome after CPB. There are several
key components of the inflammatory response
to cardiac surgery involve the complement,
immune and endothelial systems.
Cytokines may exert either proinflammatory or
antiinflammatory effects. Cytokines are essential
for immunologic and physiologic homeostasis,
are normally subject to thight homeostatic
control, and are produced in response to a variety
of physiologic and pathologic stimuli. An
uncontrolled inflammatory response appears to
play a significant role in the morbidity or mortality
observed in patients undergoing CPB. The
inflammatory response contributes to the pathogenesis
of acute pulmonary, cardiovascular,
neurologic, splanchnic, hematologic, and immune
system dysfunction following cardiac surgery.
The development of strategies to control
the inflammatory response following cardiac
surgery is currently the focus of considerable
research efforts. Diverse techniques, including
maintenance of hemodynamic stability, minimization
of exposure to CPB circuitry, and pharmacologic
and immunomodulatory agents have
been studied. Also hemofiltration, leukodepletion,
the use of serine protease inhibitors and
corticosteroids. Molecular biology is revolutionizing
medicine and the ability to assess the impact
of genetic variability on disease characterization and perioperative outcome. Recent evidence
suggests that the degree and severity of
surgical- induced inflammation may be significantly
influenced by genotype.
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