Physiological Derangement of the Trauma Patient

Enhanced Recovery after Cardiac Surgery: An Update on Clinical Implications

“…As Figure 2 illustrates, perioperative stress can activate the autonomic nervous system and the hypothalamic-pituitaryadrenal gland axis. 8 Perioperative stress and surgical injury can lead to an immunoinflammatory response. The initial response is predominantly an excessive activation of innate immune pathways manifested by a pronounced systemic inflammatory response and potential organ injury.…”

“…Recent studies indicate that innate immune receptors detect tissue injury, such as Toll-like receptor 4, and trigger the respective response. 8,10 Inflammatory cytokines are formed and released in surgical patients. These cytokines include tumor necrotizing factor, multiple interleukins, etc.…”

“…Perioperative stress induces pathophysiological changes. 8 vascular system. 13,14 Statins were found to have cardioprotective and anti-inflammatory properties perioperatively, likely by attenuation of the systemic inflammatory response and inhibition of nitric oxide metabolism.…”

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“…Severely anemic patients also exhibit organ dysfunction due to the reduced oxygen-carrying capacity. 8,9 Therefore, the true benefits of transfusion are limited to these specific indications.…”