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End-organ protection in cardiac surgery

Filip De Somer UGent (2013) MINERVA ANESTESIOLOGICA. 79(3). p.285-293
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.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (review)
publication status
published
subject
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
journal title
MINERVA ANESTESIOLOGICA
Minerva Anestesiol.
volume
79
issue
3
pages
285 - 293
Web of Science type
Review
Web of Science id
000319102300011
JCR category
ANESTHESIOLOGY
JCR impact factor
2.272 (2013)
JCR rank
13/29 (2013)
JCR quartile
2 (2013)
ISSN
0375-9393
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
3141599
handle
http://hdl.handle.net/1854/LU-3141599
date created
2013-02-25 10:55:49
date last changed
2017-06-21 07:01:44
@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},
}

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.