Systemic inflammatory response after cardiac surgery: Is extracorporeal circulation the main culprit?

  • J. Börgermann
  • I. Friedrich


Cardiac surgery with extracorporeal circulation (ECC) is associated with a systemic inflammatory response [28, 53]. Kirklin and coworkers described this phenomenon as early as 1981 and coined the term postperfusion syndrome [13]. In the majority of cases, the organism can fully compensate for this systemic inflammatory response syndrome (SIRS). But any postoperative exacerbation will increase morbidity and mortality. Surgical trauma, ischemia/reperfusion, endotoxinemia, and cellular activation induced by shear-stress and by the foreign-surfaces of the heart-lung machine are pathophysiological mechanisms that activate the systemic inflammatory response (Fig. 1).


Cardiopulmonary Bypass Serum Vascular Endothelial Growth Factor Coronary Bypass Surgery Diopulmonary Bypass Conventional Coronary Artery Bypass Grafting 
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© Springer-Verlag Berlin Heidelberg 2004

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  • J. Börgermann
  • I. Friedrich

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