TY - CHAP M1 - Book, Section TI - Chapter 12. Extracorporeal Circulation A1 - Hammon, John W. A1 - Hines, Michael H. A2 - Cohn, Lawrence H. PY - 2012 T2 - Cardiac Surgery in the Adult, 4e AB - Cardiopulmonary bypass 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 cardiopulmonary bypass 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 using cardiopulmonary bypass is essentially not possible without anticoagulation, usually with heparin; thus the inflammatory response to cardiopulmonary bypass involves the consequences of exposing heparinized blood to foreign surfaces, not lined with endothelial cells. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/28 UR - accesssurgery.mhmedical.com/content.aspx?aid=55913753 ER -