title: Pulmonary Protection Strategies in Cardiac Surgery: Are We Making Any Progress?
abstract: Pulmonary dysfunction is a common complication of cardiac surgery. The mechanisms involved in the development of pulmonary dysfunction are multifactorial and can be related to the activation of inflammatory and oxidative stress pathways. Clinical manifestation varies from mild atelectasis to severe respiratory failure. Managing pulmonary dysfunction postcardiac surgery is a multistep process that starts before surgery and continues during both the operative and postoperative phases. Different pulmonary protection strategies have evolved over the years; however, the wide acceptance and clinical application of such techniques remain hindered by the poor level of evidence or the sample size of the studies. A better understanding of available modalities and/or combinations can result in the development of customised strategies for the different cohorts of patients with the potential to hence maximise patients and institutes benefits.
authors.affiliation: Bristol Heart Institute, Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HW, UK ; Cardiac Surgery, National Heart and Lung Institute, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0HS, UK.
authors.forename: Emad
authors.initials: E
authors.lastname: Al Jaaly
authors.affiliation: Bristol Heart Institute, Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HW, UK.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Zakkar
authors.affiliation: Cardiac Surgery, National Heart and Lung Institute, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0HS, UK.
authors.forename: Francesca
authors.initials: F
authors.lastname: Fiorentino
authors.affiliation: Bristol Heart Institute, Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HW, UK ; Cardiac Surgery, National Heart and Lung Institute, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London W12 0HS, UK.
authors.forename: Gianni D
authors.initials: GD
authors.lastname: Angelini
mesh_terms: D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D006801:Humans; D007249:Inflammation; D008171:Lung Diseases / Q000209:etiology* / Q000517:prevention & control; D018384:Oxidative Stress; D044062:Prostaglandins I / Q000627:therapeutic use
chemical_list: D044062:Prostaglandins I