TY - CHAP M1 - Book, Section TI - Extracorporeal Circulation A1 - Hammon, John W. A1 - Hines, Michael H. A2 - Cohn, Lawrence H. A2 - Adams, David H. PY - 2017 T2 - Cardiac Surgery in the Adult, 5e AB - Cardiopulmonary bypass (CPB) for support during cardiac surgery is unique because blood exposed to foreign, nonendothelial cell surfaces is collected and continuously recirculated throughout the body. This contact with synthetic surfaces within the perfusion circuit, as well as open tissue surfaces within the wound, triggers a defense reaction that involves at least five plasma protein systems and five types of circulating blood cells. This inflammatory response to CPB initiates a powerful thrombotic stimulus and the production, release, and circulation of vasoactive and cytotoxic substances that affect every organ and tissue within the body. Because of this, open-heart surgery (OHS) using CPB is essentially not possible without anticoagulation, usually with heparin; thus the inflammatory response to CPB involves the consequences of exposing heparinized blood to foreign surfaces, not lined with endothelial cells. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/16 UR - accesssurgery.mhmedical.com/content.aspx?aid=1144151053 ER -