Deborah J. Kozik, DO, James S. Tweddell, MD

Slides:

Advertisements

Similar presentations

Perioperative Statin Therapy for Patients Undergoing Coronary Artery Bypass Grafting Amr F. Barakat, MD, Marwan Saad, MD, PhD, Ahmed Abuzaid, MD, Amgad.

Advertisements

From: Pulmonary Atelectasis:A Pathogenic Perioperative Entity

Biologic therapy of inflammatory bowel disease

The STS National Database

Perioperative Statin Therapy for Patients Undergoing Coronary Artery Bypass Grafting Amr F. Barakat, MD, Marwan Saad, MD, PhD, Ahmed Abuzaid, MD, Amgad.

Ian M. Adcock, PhD, Kittipong Maneechotesuwan, MD, Omar Usmani, MBBS

Pretreatment with ω-3 fatty acid infusion to prevent leukocyte–endothelial injury responses seen in cardiac surgery Jonathan McGuinness, MD, PhD, John.

Biologic therapy of inflammatory bowel disease

Vein Graft Harvesting Induces Inflammation and Impairs Vessel Reactivity Kazuhiro Hinokiyama, MD, Guro Valen, MD, PhD, Shinichi Tokuno, MD, PhD, Jenny.

Aaron M. Abarbanell, MD, Arthur C. Coffey, MD, John W

Microvascular responses to sepsis: clinical significance

Toll-like receptors in Borrelia burgdorferi-induced inflammation

From mesothelioma to cardiovascular protection via the phosphoinositide-3 kinase pathway: A new vista in cardiothoracic surgery Igor E. Konstantinov,

Functional Roles of Tumor Necrosis Factor-Alpha and Interleukin 1-Beta in Hypoxia and Reoxygenation Heather E. Merry, MD, Patrick Phelan, MD, Matthew.

Reinaldo González-Ramos, M. D. , Ph. D. , Anne Van Langendonckt, Ph. D

John J. Squiers, MD, Kevin W. Lobdell, MD, James I. Fann, MD, J

Georges Makhoul, MD, MS, Ray C.J. Chiu, MD, PhD, Renzo Cecere, MD, MS

Mechanisms of myocardial reperfusion injury

P38 Mitogen Activated Protein Kinase Mediates Both Death Signaling and Functional Depression in the Heart Meijing Wang, MD, Ben M. Tsai, MD, Mark W.

Xenobiotic receptor meets NF-κB, a collision in the small bowel

How to Keep the Treatment of Esophageal Disease in the Surgeon’s Hands

Craig H Selzman, MD, Stephanie A Miller, MD, Alden H Harken, MD

Cytokines Link Toll-Like Receptor 4 Signaling to Cardiac Dysfunction After Global Myocardial Ischemia John Cha, MD, Zhiping Wang, MD, Lihua Ao, BS, Ning.

Minimally Invasive Extracorporeal Bypass in Minimally Invasive Heart Valve Operations: A Prospective Randomized Trial Hardy Baumbach, MD, Christian J.

Cerebrospinal Fluid Markers of Brain Injury, Inflammation, and Blood-Brain Barrier Dysfunction in Cardiac Surgery Björn Reinsfelt, MD, PhD, Sven-Erik.

Andrew D. Shaw, MB, Ara A. Vaporciyan, MD, Xifeng Wu, MD, Terri M

Invited Commentary The Annals of Thoracic Surgery

Gene expression of inflammatory mediators in different chambers of the human heart Guro Valen, MD, PhD, Gabrielle Paulsson, PhD, Anna M Bennet, Göran.

Lipopolysaccharide Stimulation of Human Aortic Valve Interstitial Cells Activates Inflammation and Osteogenesis Ashok N. Babu, MD, Xianzhong Meng, MD,

Michael G. Katz, MD, PhD, Anthony S. Fargnoli, PhD, Andrew P

M.J. Martínez-Calatrava, R. Largo, G. Herrero-Beaumont

Daniel R. Meldrum, MD, Brian D

Jo-Ellen Murphy, Caroline Robert, Thomas S. Kupper

Do Statins Have a Role in the Promotion of Postoperative Wound Healing in Cardiac Surgical Patients? Gerard J. Fitzmaurice, MRCSI, MS, Billy McWilliams,

Susanne Lison, MD, Michael Spannagl, MD, PhD, Wulf Dietrich, MD, PhD

William T. Mahle, MD, Emilia Matthews, MS, Kirk R. Kanter, MD, Brian E

Origins of the Cardiothoracic Surgery Network (CTSNet)

Who Do You Say You Are? The Annals of Thoracic Surgery

Anti-inflammatory Agents: Present and Future

Reducing lipids for CV protection in CKD patients—current evidence

Endothelial Cell Injury in Cardiovascular Surgery: The Systemic Inflammatory Response1 Edward M Boyle, MD, Timothy H Pohlman, MD, Marion C Johnson, MD,

Abel Gómez-Caro, MD, Pedro Arguis, MD The Annals of Thoracic Surgery

Secretory Phospholipase A2 Inhibition Attenuates Intercellular Adhesion Molecule-1 Expression in Human Esophageal Adenocarcinoma Cells Miral R. Sadaria,

Foreign Bodies in the Esophagus

The central role of nuclear factor-κB in mesangial cell activation

Embolized Methyl Methacrylate to the Right Atrium After Kyphoplasty

Editorial Board, January 2010

Bradford B. Smith, MD, Matthew A

Endothelial Nitric Oxide Synthase in Bicuspid Aortic Valve Disease

Sarah C. Huen, MD, Chirag R. Parikh, MD, PhD

Preconditioning and cardiac surgery

Completely Thrombosed Tricuspid Pouch Mimicking a Cardiac Tumor

The Annals of Thoracic Surgery

Endothelial cell activation

NODding off in acute kidney injury with progranulin?

Sune Damgaard, MD, PhD, Claus H. Nielsen, MD, PhD, Lars W

Treating myocardial ischemia-reperfusion injury by targeting endothelial cell transcription Edward M Boyle, MD, Timothy G Canty, MD, Elizabeth N Morgan,

Robert Lee Replogle, September 30, 1931–May 9, 2016

Grethe Bergseth, BS, John D

“Transitions” for Cardiothoracic Surgeons Now Listed on the Web:

Macrophages, Immunity, and Metabolic Disease

James K Kirklin, MD, David C McGiffin, MD

Endothelial Cell Injury in Cardiovascular Surgery

Rachael L. Ford, BS, Ira M. Mains, BS, Ebony J. Hilton, BS, Scott T

Edward M. Boyle, Timothy H. Pohlman, Carol J. Cornejo, Edward D

Lobectomy Versus Limited Resection in T1N0 Lung Cancer

The Impact of New Technology on Cardiothoracic Surgical Practice

NF-κB, Inflammation, and Metabolic Disease

Airway smooth muscle: An immunomodulatory cell

J. Alberto Lopez, MD The Annals of Thoracic Surgery

Presentation transcript:

Characterizing the Inflammatory Response to Cardiopulmonary Bypass in Children Deborah J. Kozik, DO, James S. Tweddell, MD The Annals of Thoracic Surgery Volume 81, Issue 6, Pages S2347-S2354 (June 2006) DOI: 10.1016/j.athoracsur.2006.02.073 Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 An overview of the inflammatory response to cardiopulmonary bypass. Cardiopulmonary bypass exposes the body to extreme, nonphysiologic conditions that initiates a global inflammatory response. Blood–artificial surface interaction results in activation of several amplifying protein cascade systems including those of the coagulation, fibrinolytic, kallikrein, and complement systems. Additional ischemia–reperfusion injury occurs as a result of the altered flow states and hypothermia. White blood cells, platelets, and endothelial cells are activated, leading to production of additional inflammatory mediators capable of further activation of humoral and cellular elements resulting in amplifying positive feedback loops. Ultimately capillary integrity is altered and multisystem organ dysfunction occurs. (IL = interleukin; TNF = tumor necrosis factor.) The Annals of Thoracic Surgery 2006 81, S2347-S2354DOI: (10.1016/j.athoracsur.2006.02.073) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Contact of the blood with foreign surfaces results in production of kallikrein. Kallikrein enters into a positive feedback loop with factor XII, activating both the coagulation cascade and the fibrinolytic system. Kallikrein results in production of bradykinin. In addition kallikrein activates the renin–angiotensin system and complement cascades. (HMW = high-molecular-weight.) (Reprinted from Murkin JM. Cardiopulmonary bypass and the inflammatory response: a role for serine protease inhibitors? J Cardiothoracic Vasc Anesth 1997:11(Suppl 2):19–23, by permission of Elsevier Science, Inc.) The Annals of Thoracic Surgery 2006 81, S2347-S2354DOI: (10.1016/j.athoracsur.2006.02.073) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Function of transcription factor nuclear factor kappa B (NF-κB). In the inactive state NF-κB is found in the cytoplasm of endothelial cells. With stimulation by a variety of agents, including proinflammatory cytokines and other mediators of inflammation, the inhibitory IκB subunit is phosphorylated and separates from the heterodimer. Nuclear factor kappa B then translocates to the nucleus, where it upregulates transcription of inflammatory genes including proinflammatory cytokines, adhesion molecules, and inducible nitric oxide synthase. These protein products are themselves activators of NF-κB, and this action results in a positive feedback loop. (Reprinted from [2] by permission of Cambridge University Press.) The Annals of Thoracic Surgery 2006 81, S2347-S2354DOI: (10.1016/j.athoracsur.2006.02.073) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions