Cytokine release regarding different perfusion systems and its effect on S100B protein levels
During cardiopulmonary bypass (CPB), blood is exposed to foreign surfaces and abnormal sheer forces. These abnormal conditions lead to an activation of coagulation (9), fibrinolysis (9), the complement pathway (2) and of the cellular and humoral immune system (15), finally resulting in a general inflammatory reaction. Clinically, this so-called “post pump response” is linked to myocardial dysfunction, respiratory distress, renal failure, and neurological deficits. All these clinical aspects are mostly consequences of endothelial injury and increased vascular permeability — at least partly caused by the release of cytokines, which are known to mediate vascular injury and organ dysfunction (4, 14).
KeywordsCardiopulmonary Bypass Centrifugal Pump Perfusion System Protamine Administration S100B Concentration
Unable to display preview. Download preview PDF.
- 8.Gorman RC, Ziats NP, Rao AK, Gikakis N, Sun L, Kahn MMH, Stenach N, Sapatnekar S, Chouhan V, Gorman JH, Niewiarowski S, Colman RW, Anderson JM, Edmunds LH (1996) Surface-bound heparin fails to reduce thrombin formation during clinical cardiopulmonary bypass. J Thorac Cardiovasc Surg 111:1–12PubMedCrossRefGoogle Scholar
- 10.Hennein HA, Ebba H, Rodriguez JL, Merrick SH, Keith FM, Bronstein MH, Leung JM, Mangano DT, Greenfield LJ, Rankin JS (1994) Relationship of the proinflammatory cytokines to myocardial ischemia and dysfunction after uncomplicated coronary revascularization. J Thorac Cardiovasc Surg 108:626–635PubMedGoogle Scholar
- 12.Jansen PGM, te Velthuis H, Huybregts RAJM, Paulus R, Bulder ER, van der Spoel HI, Bezemer PD, Slaats EH, Eijsman L, Wildevuur CHR (1995) Reduced complement activation and improved postoperative performance after cardiopulmonary bypass with heparin-coated circuits. J Thorac Cardiovasc Surg 110:829–834PubMedCrossRefGoogle Scholar
- 17.Prodzinsky R, Witthaut R, Stabenow I, Lehrmann D, Redling F, Fraunberger P, Walli AK, Seidel D, Zerkowski HR, Teichmann W, Werdan K (1997) The cardiopulmonary bypass supported high-risk PTCA (CPB-PTCA): a useful model for the study of CPB-dependent systemic inflammatory response syndrom (SIRS)? Crit Care l(Suppl 1):S41Google Scholar