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心脏外科手术中心肺绕道的生物化学变化:新的见解

Luan Oliveira Ferreira^1,2, Victoria Winkler Vasconcelos¹, Janielle de Sousa Lima¹

¹Residency Program in Anesthesiology, João de Barros Barreto University Hospital, Federal University of Pará, Belém 66073-000, Brazil.

Journal of personalized medicine

|October 27, 2023

概括

使用心肺旁路 (CPB) 的冠状动脉再血管化引发全身炎症反应,可能损害器官. 本综述探讨了缓解这种炎症风暴的手术内策略,旨在改善患者的治疗结果并降低死亡率.

科学领域:

心血管外科心血管外科
炎症生物学炎症生物学
关键护理医学关键护理医学

背景情况:

通过心肺绕道 (CPB) 进行冠状动脉再血管化可以诱导微循环中的显著生化变化.
这些变化激活炎症通路,导致细胞因子释放,氧化应激,以及潜在的器官损伤,特别是心脏损伤.
这种系统性炎症反应有助于术后并发症和增加死亡率.

研究的目的:

审查在体外循环期间和之后的炎症风暴的病理生理学.
探索新的手术内治疗和管理策略,以减少这种炎症反应.
确定可能改善患者预后并降低CPB后死亡率的方法.

主要方法:

关于研究心肺旁路术的炎症反应的文献综述.
在体外循环过程中分析生化变化和细胞激活.
评估当前和新兴的内科手术干预措施,以管理系统性炎症.

主要成果:

手术创伤,再注射损伤和血液物质相互作用激活炎症级联.
细胞因子的产生和氧化应激是CPB诱导炎症的关键媒介.
器官损伤,尤其是心肌损伤,是这种炎症风暴的重要后果.

结论:

了解CPB诱导的炎症机制对于患者管理至关重要.
针对炎症反应的内科手术干预措施有望改善外科手术结果.
减少炎症风暴可能会显著改善预后,并降低CPB重血管化的患者的死亡率.

关键词:

心脏外科手术的心脏手术通过心肺旁路术 (cardiopulmonary bypass) 进行心肺旁路术.细胞因子细胞因子这是一种炎症炎症炎症炎症.乳酸乳酸是一种乳酸.

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