Partitioning of exhaled NO in ventilated patients undergoing cardiac surgery

Immune Dysfunction After Cardiac Surgery with Cardiopulmonary Bypass

“…Indeed, we found that maintaining MV during CPB improved postoperative index of oxygenation. This result was expected and several studies have already demonstrated the beneficial effects of MV with PEEP during cardiac surgery with CPB [10][11][12]. As previously reported, postoperative plasmatic levels of CXCL10 and CCL2 were significantly increased [29].…”

“…Secondly, CPB induces a pulmonary dysfunction which ranges from a temporary and clinically insignificant reduction in arterial oxygenation to a lifethreatening injury manifested as acute respiratory distress syndrome. This phenomenon is of multifactorial sources but one of the main mechanisms is the occurrence of atelectasis during surgery [8][9][10][11][12][13][14][15]. Atelectasis have been associated with lung injury and release of cytokines (TNF-α) by shear forces on alveoli and small airways [12][13][14][15].…”

“…This phenomenon is of multifactorial sources but one of the main mechanisms is the occurrence of atelectasis during surgery [8][9][10][11][12][13][14][15]. Atelectasis have been associated with lung injury and release of cytokines (TNF-α) by shear forces on alveoli and small airways [12][13][14][15]. However, it is not clear whether this injury is due to a recruitment/de-recruitment phenomenon (ie atelectrauma) or whether it might by itself lead to the release of cytokines [15][16][17].…”

“…However, it is not clear whether this injury is due to a recruitment/de-recruitment phenomenon (ie atelectrauma) or whether it might by itself lead to the release of cytokines [15][16][17]. Nevertheless, addition of a positive end-expiratory pressure (PEEP) during CPB for cardiac surgery diminished the occurrence of atelectasis and the postoperative inflammatory response without hampering the surgical progress [10][11][12].…”