Inflammatory Response in Patients under Coronary Artery Bypass Grafting Surgery and Clinical Implications: A Review of the Relevance of Dexmedetomidine Use

Scheme 1

Cardiopulmonary bypass and the extracorporeal circulation responses with the pathophysiologic changes resembling the systemic inflammatory response syndrome (SIRS). The contact of blood with xenosurfaces of the extracorporeal machine device, the ischemia/reperfusion, and the hyperbaric oxygen triggered SIRS-like pathophysiological responses. The SIRS-like response is associated with overactivation of leukocytes, platelets (which can contribute to an increased coagulopathy), and endothelial and cardiac cell. The secretion of proinflammatory factors by leucocytes and the increase tension and blood oxygenation stimulate the overproduction of reactive oxygen species (ROS), which feeds a vicious cycle of inflammation ⟺ROS production.