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Coronary Artery Disease: Research and Practice
Title
Coronary Artery Disease: Research and Practice
Editor
iConcept Press
Price
USD$39.00
ISBN
978-1-922227-98-0
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7013

Chapter 6

Coronary Artery Disease: Research and Practice

Inflammatory Stress during Cardiac Surgery

by Gaurav Jain, Ghanshyam Yadav and Yashpal Singh

Viewed: 541

Abstract

The advent of cardiopulmonary bypass has revolutionized various prospects of cardiac surgery and contributed invaluably to improved patient outcome. It is a well-known fact that cardiac surgery predisposes the patients to multifaceted non-physiological stress during which vital organs are exposed to severe functional alterations. This leads to the activation of various coagulation, pro-inflammatory, survival cascades and altered redox state presenting as generalized systemic inflammatory response, which has an adverse effect on the functioning and recovery of multiple organs such as the myocardium, lungs, and kidneys after cardiac surgery. This manifests as delayed post-operative recovery, prolonged hospital stay and eventual increase in mortality and morbidity. Under physiological environment, the effects of pro-inflammatory cascade are consistently neutralized by antioxidants, the molecules that are capable of neutralizing free radicals by accepting or donating electron(s) thereby eliminating the unpaired condition of the radical. The antioxidant molecules may directly react with the reactive radicals and destroy them, while they may become new free radicals which are less active, longer-lived, and less dangerous than those radicals they have neutralized. The administration of antioxidant agents such as propofol, L-arginine, N-acetyl-cysteine, and ulinastatin during the cardiac surgery, aids to target the rapid oxidative stress during the procedure. Alternatively, the use of improvised circuits such as mini-bypass could limit both pro-inflammatory responses and oxidative cascade during surgery. In spite of some major refinements in surgical procedure in the last decade, oxidative stress and inflammation has remained a major concern when performing cardiac surgery.

Author Details

Gaurav Jain
Department of anaesthesia and intensive care, Institute of medical sciences, Banaras Hindu University, Varanasi, UP, India
Ghanshyam Yadav
Department of anaesthesia and intensive care, Institute of medical sciences, Banaras Hindu University, Varanasi, UP, India
Yashpal Singh
Department of anaesthesia and intensive care, Institute of medical sciences, Banaras Hindu University, Varanasi, UP, India

Citation

Gaurav Jain, Ghanshyam Yadav and Yashpal Singh. Inflammatory Stress during Cardiac Surgery. In Coronary Artery Disease: Research and Practice. ISBN:978-1-922227-98-0. iConcept Press. 2016.

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