title: Treatment of sepsis in cardiac surgery: role of immunoglobulins.
abstract: Cardiopulmonary bypass (CPB) is associated with an injury that may cause pathophysiological changes such as systemic inflammatory response syndrome, multiple organ dysfunction syndrome, and mediator-induced multiorgan failure. Systemic endotoxinaemia, release of proinflammatory cytokines, and interactions between neutrophils and endothelium have been reported to correlate with a high incidence of organ dysfunction, infection and sepsis following cardiac surgery. This review discusses the dysregulation of the immune response as a major reason for the higher susceptibility to infections following cardiac surgery, various treatment strategies to reduce CPB-induced inflammation, and especially the prophylactic use of immunoglobulins in cardiac surgery.
authors.affiliation: Clinic of Anaesthesiology and Intensive Care Medicine, Martin-Luther-University, Halle/Wittenberg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Sablotzki
authors.forename: J
authors.initials: J
authors.lastname: Mühling
authors.forename: M G
authors.initials: MG
authors.lastname: Dehne
authors.forename: B
authors.initials: B
authors.lastname: Zickmann
authors.forename: R E
authors.initials: RE
authors.lastname: Silber
authors.forename: I
authors.initials: I
authors.lastname: Friedrich
mesh_terms: D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D016207:Cytokines / Q000009:adverse effects / Q000097:blood; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D018836:Inflammation Mediators / Q000009:adverse effects / Q000097:blood; D018805:Sepsis / Q000188:drug therapy* / Q000209:etiology
chemical_list: D016207:Cytokines; D016756:Immunoglobulins, Intravenous; D018836:Inflammation Mediators