Treatment of sepsis in cardiac surgery: role of immunoglobulins.
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.
Sablotzki
A
A
Clinic of Anaesthesiology and Intensive Care Medicine, Martin-Luther-University, Halle/Wittenberg, Germany.
Mühling
J
J
Dehne
M G
MG
Zickmann
B
B
Silber
R E
RE
Friedrich
I
I
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
D016207:Cytokines; D016756:Immunoglobulins, Intravenous; D018836:Inflammation Mediators