Characterizing the inflammatory response to cardiopulmonary bypass in children.
Cardiopulmonary bypass is known to trigger a global inflammatory response. Age-dependent differences in the inflammatory response, the increased susceptibility to injury of immature organ systems, and the larger extracorporeal circuit to patient size ratio results in greater susceptibility of younger and smaller patients to the damaging effects of cardiopulmonary bypass. In this review the components of the inflammatory response to cardiopulmonary bypass are reviewed with special reference to the pediatric age group, including the age-specific impact on organ systems. In addition the current and evolving strategies to prevent, limit, and treat the inflammatory response to cardiopulmonary bypass in children are examined.
Kozik
Deborah J
DJ
The Herma Heart Center, Children's Hospital of Wisconsin, Milwaukee, Wisconsin 53226, USA.
Tweddell
James S
JS
D000367:Age Factors; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D007611:Aprotinin / Q000627:therapeutic use; D001672:Biocompatible Materials; D001777:Blood Coagulation / Q000502:physiology; D049628:Body Size; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003167:Complement Activation; D016207:Cytokines / Q000502:physiology; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000209:etiology; D007223:Infant; D007231:Infant, Newborn; D018836:Inflammation Mediators / Q000502:physiology*; D007610:Kallikreins / Q000502:physiology; D007705:Kinins / Q000502:physiology; D008213:Lymphocyte Activation; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D009928:Organ Specificity; D015539:Platelet Activation; D051381:Rats; D015398:Signal Transduction; D018746:Systemic Inflammatory Response Syndrome / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy; D014781:Viscera / Q000503:physiopathology
D000893:Anti-Inflammatory Agents; D001672:Biocompatible Materials; D016207:Cytokines; D018836:Inflammation Mediators; D007705:Kinins; D007611:Aprotinin; D007610:Kallikreins