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End-organ protection in cardiac surgery

Filip De Somer (UGent)
(2013) MINERVA ANESTESIOLOGICA. 79(3). p.285-293
Author
Organization
Abstract
Mortality and morbidity postcardiac surgery with cardiopulmonary bypass (CPB) remain relative stable over the last decades, while the number of patients with increased comorbidity and more complex cardiac disease increases. Nevertheless, end-organ dysfunction and/or failure remain an issue. Multiple perioperative variables, such as non-optimal oxygen delivery, manipulation of the aorta, hyperlactatemia, type of anesthesia, surgical procedure and myocardial protection can be hold responsible for end-organ failure postcardiac surgery. However, it becomes more and more evident that also pre-existing factors, such as metabolic syndrome, renal insufficiency, hypertension, stroke and infection exacerbate mortality and morbidity. Unfortunately, these predisposing risk factors cannot be influenced perioperatively. Therefore, therapy should focus on controlling perioperative variables that, in combination with the predisposing factors, will further exacerbate organ dysfunction. In order to achieve this, more emphasis should be given to a patient-specific, goal-directed perfusion approach. This review will mainly focus on the impact of perioperative variables.
Keywords
Cardiac surgery, Multiple organ failure, Cardiopulmonary bypass, BYPASS GRAFT-SURGERY, SYSTEMIC INFLAMMATORY RESPONSE, EUROSCORE MULTINATIONAL DATABASE, CARBON-DIOXIDE DIFFERENCE, ACUTE KIDNEY INJURY, OPEN-HEART-SURGERY, OXYGEN DELIVERY, NITRIC-OXIDE, OFF-PUMP, CARDIOPULMONARY BYPASS

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Citation

Please use this url to cite or link to this publication:

Chicago
De Somer, Filip. 2013. “End-organ Protection in Cardiac Surgery.” Minerva Anestesiologica 79 (3): 285–293.
APA
De Somer, F. (2013). End-organ protection in cardiac surgery. MINERVA ANESTESIOLOGICA, 79(3), 285–293.
Vancouver
1.
De Somer F. End-organ protection in cardiac surgery. MINERVA ANESTESIOLOGICA. 2013;79(3):285–93.
MLA
De Somer, Filip. “End-organ Protection in Cardiac Surgery.” MINERVA ANESTESIOLOGICA 79.3 (2013): 285–293. Print.
@article{3141599,
  abstract     = {Mortality and morbidity postcardiac surgery with cardiopulmonary bypass (CPB) remain relative stable over the last decades, while the number of patients with increased comorbidity and more complex cardiac disease increases. Nevertheless, end-organ dysfunction and/or failure remain an issue. Multiple perioperative variables, such as non-optimal oxygen delivery, manipulation of the aorta, hyperlactatemia, type of anesthesia, surgical procedure and myocardial protection can be hold responsible for end-organ failure postcardiac surgery. However, it becomes more and more evident that also pre-existing factors, such as metabolic syndrome, renal insufficiency, hypertension, stroke and infection exacerbate mortality and morbidity. Unfortunately, these predisposing risk factors cannot be influenced perioperatively. Therefore, therapy should focus on controlling perioperative variables that, in combination with the predisposing factors, will further exacerbate organ dysfunction. In order to achieve this, more emphasis should be given to a patient-specific, goal-directed perfusion approach. This review will mainly focus on the impact of perioperative variables.},
  author       = {De Somer, Filip},
  issn         = {0375-9393},
  journal      = {MINERVA ANESTESIOLOGICA},
  keyword      = {Cardiac surgery,Multiple organ failure,Cardiopulmonary bypass,BYPASS GRAFT-SURGERY,SYSTEMIC INFLAMMATORY RESPONSE,EUROSCORE MULTINATIONAL DATABASE,CARBON-DIOXIDE DIFFERENCE,ACUTE KIDNEY INJURY,OPEN-HEART-SURGERY,OXYGEN DELIVERY,NITRIC-OXIDE,OFF-PUMP,CARDIOPULMONARY BYPASS},
  language     = {eng},
  number       = {3},
  pages        = {285--293},
  title        = {End-organ protection in cardiac surgery},
  volume       = {79},
  year         = {2013},
}

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