title: Does pharmacotherapy influence the inflammatory responses during cardiopulmonary bypass in children?
abstract: Cardiopulmonary bypass (CPB) induces a systemic inflammatory response syndrome (SIRS) by factors such as contact of the blood with the foreign surface of the extracorporeal circuit, hypothermia, reduction of pulmonary blood flow during CPB and endotoxemia. SIRS is maintained in the postoperative phase, co-occurring with a counter anti-inflammatory response syndrome. Research on the effects of drugs administered before the surgery, especially in the induction phase of anesthesia, as well as drugs used during extracorporeal circulation, has revealed that they greatly influence these postoperative inflammatory responses. A better understanding of these processes may not only improve postoperative recovery but also enable tailor-made pharmacotherapy, with both health and economic benefits. In this review, we describe the pathophysiology of SIRS and counter anti-inflammatory response syndrome in the light of CPB in children and the influence of drugs used on these syndromes.
authors.affiliation: *Intensive Care Unit, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands; †Department of Anesthesiology, Intensive Care Unit, Erasmus MC, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands; and ‡Department of Cardiothoracic Surgery, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Berber
authors.initials: B
authors.lastname: Kapitein
authors.forename: Anne-Wil
authors.initials: AW
authors.lastname: van Saet
authors.forename: Hanna D
authors.initials: HD
authors.lastname: Golab
authors.forename: Matthijs
authors.initials: M
authors.lastname: de Hoog
authors.forename: Saskia
authors.initials: S
authors.lastname: de Wildt
authors.forename: Dick
authors.initials: D
authors.lastname: Tibboel
authors.forename: Ad J J C
authors.initials: AJ
authors.lastname: Bogers
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000777:Anesthetics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D002648:Child; D016207:Cytokines / Q000276:immunology; D006801:Humans; D007107:Immune System / Q000187:drug effects; D018746:Systemic Inflammatory Response Syndrome / Q000139:chemically induced / Q000276:immunology / Q000517:prevention & control
chemical_list: D000701:Analgesics, Opioid; D000777:Anesthetics; D000893:Anti-Inflammatory Agents; D016207:Cytokines