Ruel Marc, Khan Tanveer A, Voisine Pierre, Bianchi Cesario, Sellke Frank W
Division of Cardiothoracic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
Eur J Cardiothorac Surg. 2004 Nov;26(5):1002-14. doi: 10.1016/j.ejcts.2004.07.040.
Cardiopulmonary bypass and cardioplegic arrest, which allow for support of the circulation and stabilization of the heart during cardiac procedures, are still used for the vast majority of cardiac operations worldwide. However, in addition to a well-recognized systemic inflammatory response, cardiopulmonary bypass and cardioplegic arrest elicit complex, multifactorial vasomotor disturbances that vary according to the affected organ bed, with reduced vascular resistances in the skeletal muscle and peripheral circulation, and increased propensity to spasm in the cardiac, pulmonary, mesenteric and cerebral vascular beds. This article outlines the nature, mechanistic basis, and clinical correlates of the vasomotor alterations encountered in patients undergoing cardiac surgery using cardiopulmonary bypass and cardioplegic arrest.
体外循环和心脏停搏可在心脏手术期间维持循环支持并稳定心脏，目前仍在全球绝大多数心脏手术中使用。然而，除了众所周知的全身炎症反应外，体外循环和心脏停搏还会引发复杂的、多因素的血管运动紊乱，这种紊乱因受影响的器官床而异，骨骼肌和外周循环的血管阻力降低，而心脏、肺、肠系膜和脑血管床的痉挛倾向增加。本文概述了在接受体外循环和心脏停搏的心脏手术患者中遇到的血管运动改变的性质、机制基础和临床相关性。
