Cardiopulmonary bypass and oxidative stress.
The development of the cardiopulmonary bypass (CPB) revolutionized cardiac surgery and contributed immensely to improved patients outcomes. CPB is associated with the activation of different coagulation, proinflammatory, survival cascades and altered redox state. Haemolysis, ischaemia, and perfusion injury and neutrophils activation during CPB play a pivotal role in oxidative stress and the associated activation of proinflammatory and proapoptotic signalling pathways which can affect the function and recovery of multiple organs such as the myocardium, lungs, and kidneys and influence clinical outcomes. The administration of agents with antioxidant properties during surgery either intravenously or in the cardioplegia solution may reduce ROS burst and oxidative stress during CPB. Alternatively, the use of modified circuits such as minibypass can modify both proinflammatory responses and oxidative stress.
Bristol Royal Infirmary, Level 7, Upper Maudlin Street, Bristol BS2 8HW, UK.
Mustafa
M
Zakkar
Bristol Royal Infirmary, Level 7, Upper Maudlin Street, Bristol BS2 8HW, UK.
Gustavo
G
Guida
Bristol Royal Infirmary, Level 7, Upper Maudlin Street, Bristol BS2 8HW, UK.
M-Saadeh
MS
Suleiman
Bristol Royal Infirmary, Level 7, Upper Maudlin Street, Bristol BS2 8HW, UK.
Gianni D
GD
Angelini
D000818:Animals; D000975:Antioxidants / Q000494:pharmacology; D002315:Cardiopulmonary Bypass; D006801:Humans; D007249:Inflammation; D007511:Ischemia / Q000378:metabolism / Q000473:pathology; D018375:Neutrophil Activation; D018384:Oxidative Stress / Q000187:drug effects; D017382:Reactive Oxygen Species / Q000378:metabolism
D000975:Antioxidants; D017382:Reactive Oxygen Species