Prevention of pulmonary alterations after cardiopulmonary bypass

Judita Andrejaitienė, Edmundas Širvinskas, Renata Bazelienė¹

Institute for Biomedical Research, Kaunas University of Medicine, Clinic of Cardiosurgery, Kaunas University of Medicine, ¹Kaunas University of Medicine, Lithuania

Key words: lung injury, cardiopulmonary bypass, systemic inflammatory response syndrome, prevention of pulmonary alterations.

Summary. Postoperative lung injury is one of the most frequent complications in cardiac surgery that has a significant impact on health care expenditures and largely has been believed to result from the use of cardiopulmonary bypass. Cardiopulmonary bypass induces the whole body inflammatory response leading to postoperative lung dysfunction. Pulmonary complications after these operations take the first place in morbidity and mortality rates. Despite the modern technologies and new surgical techniques, cases of pulmonary alterations after cardiopulmonary bypass are not rare. Therefore, the prevention of such alterations is an urgent problem worldwide. Still it is not known what is the cause of pulmonary alterations, as well as there are no means to prevent them. In our paper we review the international studies in order to present worldwide practice of prevention of pulmonary alterations using various methods of mechanical lung ventilation.

Correspondence to E. Širvinskas, Institute for Biomedical Research, Kaunas University of Medicine, Eivenių 4, 50010 Kaunas, Lithuania

Received 19 May 2003, accepted 12 January 2004