During cardiac surgery different factors, such as the aortic clamp, the extracorporeal
circulation and the surgical injury itself, produce complex inflammatory responses which can lead to
varying degrees of ischemia-reperfusion injury and/or systemic inflammatory response. This may have
clinical implications due to hemodynamic changes related with an enlarged vasodilatory response.
Thus, maintaining adequate levels of blood pressure during and after cardiac surgery represents a
challenge for physicians when inflammatory response appears. The use of noradrenaline to raise
arterial pressure is the most current pharmacological approach in the operating room and ICU. However, it is not always
effective and other drugs, such as methylene blue, have to be used among others in specific cases as rescue therapy. The
aim of our research is to review briefly the pathophysiology and clinical implications in the treatment of the inflammatory
response in cardiac surgery, together with the mechanisms involved in those treatments.
Keywords: Cardiac surgery, cardiopulmonary bypass, systemic inflammatory response syndrome, vasopressors.
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