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Oxidative Medicine and Cellular Longevity
Volume 2015 (2015), Article ID 189863, 8 pages
http://dx.doi.org/10.1155/2015/189863
Review Article

Cardiopulmonary Bypass and Oxidative Stress

Bristol Royal Infirmary, Level 7, Upper Maudlin Street, Bristol BS2 8HW, UK

Received 29 December 2014; Accepted 19 January 2015

Academic Editor: Giuseppe Cirillo

Copyright © 2015 Mustafa Zakkar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The development of the cardiopulmonary bypass (CPB) revolutionized cardiac surgery and contributed immensely to improved patients outcomes. CPB is associated with the activation of different coagulation, proinflammatory, survival cascades and altered redox state. Haemolysis, ischaemia, and perfusion injury and neutrophils activation during CPB play a pivotal role in oxidative stress and the associated activation of proinflammatory and proapoptotic signalling pathways which can affect the function and recovery of multiple organs such as the myocardium, lungs, and kidneys and influence clinical outcomes. The administration of agents with antioxidant properties during surgery either intravenously or in the cardioplegia solution may reduce ROS burst and oxidative stress during CPB. Alternatively, the use of modified circuits such as minibypass can modify both proinflammatory responses and oxidative stress.