Lung injury after cardiopulmonary bypass: Alternative treatment prospects

doi:10.12998/wjcc.v10.i3.753

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World Journal of Clinical Cases

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World J Clin Cases. Jan 21, 2022; 10(3): 753-761
Published online Jan 21, 2022. doi: 10.12998/wjcc.v10.i3.753

Lung injury after cardiopulmonary bypass: Alternative treatment prospects

Xue-Mei Zheng, Zhuo Yang, Guang-Li Yang, Yan Huang, Jie-Ru Peng, Meng-Jun Wu

Xue-Mei Zheng, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610000, Sichuan Province, China

Zhuo Yang, Department of Pharmacy, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610000, Sichuan Province, China

Guang-Li Yang, Department of Medical Administration, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610000, Sichuan Province, China

Yan Huang, National Institute of Drug Clinical Trial, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610000, Sichuan Province, China

Jie-Ru Peng, Department of Medical Records Statistics, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610000, Sichuan Province, China

Meng-Jun Wu, Department of Anesthesiology, The Affiliated Hospital, School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology, Chengdu 610000, Sichuan Province, China

Author contributions: Zheng XM, Yang Z and Yang GL contributed equally to this work; Wu MJ designed the research study; Zheng XM, Yang Z collected data from the literature; Zheng XM, Yang Z, Peng JR, Huang Y and Yang GL wrote the manuscript; Wu MJ conducted a review of the manuscript; all authors have read and approve the final manuscript.

Conflict-of-interest statement: The authors have no potential conflicts of interest to disclose.

Corresponding author: Meng-Jun Wu, MD, PhD, Associate Chief Physician, Department of Anesthesiology, The Affiliated Hospital, School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology, No. 1617 Riyue Avenue, Qingyang District, Chengdu 610000, Sichuan Province, China. 3400164739@qq.com

Received: August 10, 2021
Peer-review started: August 10, 2021
First decision: October 20, 2021
Revised: October 29, 2021
Accepted: December 23, 2021
Article in press: December 23, 2021
Published online: January 21, 2022
Processing time: 158 Days and 1.8 Hours

Abstract

Although the lung injury caused by cardiopulmonary bypass (CPB) has been extensively investigated, the incidence and mortality of lung injury after CPB remain a prominent clinical problem. The poor outcome has been attributed to multifactorial etiology, including the systemic inflammatory response and ischemia reperfusion (I/R) injury during CPB. Lung injury after CPB is a complex pathophysiological process and has many clinical manifestations of mild to severe disease. Which is associated with prognosis. To alleviate this lung injury, interventions that address the pathogenesis are particularly important. This review summarizes the pathogenesis, mechanism and treatment options of lung injury after CPB, such as lung protection with intralipid.

Keywords: Cardiopulmonary bypass; Lung injury; Pathogenesis; Treatment; Intralipid; Systemic inflammatory response syndrome

Core Tip: Respiratory dysfunction is a well-recognized side effect of cardiac surgery combined with cardiopulmonary bypass (CPB). The mechanism of lung injury after CPB is unclear, and the lack of effective treatment results in poor prognosis. This review summarizes the mechanisms of lung injury and proposes a new treatment option.