Valenzuela-Flores A Gabriela, Valenzuela-Flores Adriana Abigail, Ortega-Ramírez J Alberto, Penagos-Paniagua Martín, Pérez-Campos José Pascual
Servicio de Medicina Nuclear, Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano de Seguro Social.
Cir Cir. 2005 Mar-Apr;73(2):143-9.
Cardiopulmonary bypass (CPB) is one of the methods used in myocardial revascularization and can be associated with adverse events that are uncommon, but CPB induces high morbidity and mortality. Cardiac surgery and CPB activate a systemic inflammatory response characterized by tissular lesions, cells movements and blood flow toward the interstice where the harmful stimulus has begun, under the influence of the mediators. The systemic inflammatory response may be initiated during cardiac surgery by a number of processes, including blood contact with the foreign surface of the CPB apparatus, development of ischemia and reperfusion injury, and presence of endotoxemia. In the course of cardiac surgery using CPB, all three processes are present and contribute concurrently to the systemic inflammatory response. The term "systemic inflammatory response syndrome" (SIRS) has been proposed to describe an entity that continually overlaps with normal postoperative physiology. A frequent complication of SIRS is the development of organ dysfunction, including acute lung injury, shock, renal failure, and multiple organ dysfunction syndrome. Finally, long-term survival in patients developing SIRS may also be adversely affected. The purpose of this review is to examine and understand the pathological mechanisms for inflammatory response that occur following cardiopulmonary bypass.
体外循环（CPB）是心肌血运重建所采用的方法之一，可能会引发一些虽不常见但却会导致高发病率和死亡率的不良事件。心脏手术和体外循环会激活一种全身性炎症反应，其特征为组织损伤、细胞移动以及在介质的影响下血流流向有害刺激起始的间隙处。全身性炎症反应可能在心脏手术过程中由多种过程引发，包括血液与体外循环装置的异物表面接触、缺血再灌注损伤的发生以及内毒素血症的存在。在使用体外循环的心脏手术过程中，这三个过程均存在且共同促成全身性炎症反应。“全身性炎症反应综合征”（SIRS）这一术语已被提出用于描述一种与正常术后生理状态持续重叠的实体。SIRS的一个常见并发症是器官功能障碍的发生，包括急性肺损伤、休克、肾衰竭和多器官功能障碍综合征。最后，发生SIRS的患者的长期生存也可能受到不利影响。本综述的目的是研究和理解体外循环后发生的炎症反应的病理机制。
