Inflammatory mechanism of lung injury induced by cardiopulmonary bypass.docVIP

 PAGE \* MERGEFORMAT 17 Inflammatory mechanism of lung injury induced by cardiopulmonary bypass [Keywords:] cardiopulmonary bypass; lung injury; complement; inflammatory response CPB (cardiopulmonary bypass, CPB), after lung injury is the systemic inflammatory response as part of its performance for the majority of sub-clinical symptoms of functional changes, and only less than 2% of patients showed acute respiratory distress syndrome (ARDS) [1] . ARDS case fatality rate greater than 50%, and can significantly prolong postoperative recovery and hospital stay. Despite years of research, but its pathophysiological mechanism is complex and not fully understood. Is now on the CPB-induced lung injury mechanisms to do a review. 1 CPB in the body fluids, the relationship between media and lung injury 1.1 Complement activation of complement is a group of plasma globulin, plasma protein of approximately 20 species composition, with a white blood cell activation, cell lysis, and opsonization three kinds of functions, constitute the body’s defense mechanisms, play a role in the early inflammatory response. During CPB, blood components and foreign bodies in the surface due to extensive contacts as well as the application of protamine by and bypass two ways to activate the classical complement system. 2 min after the start of CPB in plasma C3 levels began to rise, C3 is the classical pathway and the bypass route (see Figure 1), the hub of one but was activated that quickly led to ‘inflammatory cascade’ outbreak, its main product is the anaphylatoxin C3a and C5a . Protamine and heparin triggered the classical pathway of complement activation, so that elevated levels of C4a and C3a levels increased further in the cycle of endotoxin release via two ways to activate complement. Complement activation produced by anaphylatoxin (C3a, C4a, C5a) with the promotion of mast cells and basophils to release histamine and other inflammatory mediators, resulting in increased permeabili