title: The inflammatory response in cardiac surgery: an overview of the pathophysiology and clinical implications.
abstract: During cardiac surgery different factors, such as the aortic clamp, the extracorporeal circulation and the surgical injury itself, produce complex inflammatory responses which can lead to varying degrees of ischemia-reperfusion injury and/or systemic inflammatory response. This may have clinical implications due to hemodynamic changes related with an enlarged vasodilatory response. Thus, maintaining adequate levels of blood pressure during and after cardiac surgery represents a challenge for physicians when inflammatory response appears. The use of noradrenaline to raise arterial pressure is the most current pharmacological approach in the operating room and ICU. However, it is not always effective and other drugs, such as methylene blue, have to be used among others in specific cases as rescue therapy. The aim of our research is to review briefly the pathophysiology and clinical implications in the treatment of the inflammatory response in cardiac surgery, together with the mechanisms involved in those treatments.
authors.forename: Vicente
authors.initials: V
authors.lastname: Corral-Velez
authors.affiliation: Hospital Universitari de Bellvitge, Intensive Care Department, C/Feixa Llarga s/n. 08907, L'Hospitalet de Llobregat, Barcelona, Spain. juancarloslopezde@hotmail.com.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Lopez-Delgado
authors.forename: Nelson L
authors.initials: NL
authors.lastname: Betancur-Zambrano
authors.forename: Neus
authors.initials: N
authors.lastname: Lopez-Suñe
authors.forename: Mariel
authors.initials: M
authors.lastname: Rojas-Lora
authors.forename: Herminia
authors.initials: H
authors.lastname: Torrado
authors.forename: Josep
authors.initials: J
authors.lastname: Ballus
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007249:Inflammation / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology*; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology / Q000503:physiopathology