Pathophysiology Of Cardiopulmonary Bypass

Cardiopulmonary bypass is not physiologic. It results in several metabolic derangements including a bleeding tendency (secondary to platelet sequestration, clumping in the oxygenator, and diffuse systemic inflammatory reaction with third spacing); this will be discussed in detail.

Vasoconstriction occurs as a result of the catecholamine storm, hemolysis secondary to red blood cell trauma and sheer stress and protein denaturation within the oxygenator. The diffuse systemic inflammatory reaction occurring from cardiopulmonary bypass all centers about activation of Hageman factor 12 by the

Fig. 3.4. Left atrial-femoral bypass.

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