Full Description
Over the past ?fty years, advanced techniques and strategies have arisen in the ?eld of myocardial protection. Meticulous trials, focusing on pulmonary protection during heart surgery requiring cardiopulmonary bypass (CPB), have been missing. This te- book is intended to serve as a useful tool to spread information on strategies for lung protection during heart surgery with CPB. Emphasis on pulmonary protection will be turned to lung perfusion as an adjunct for minimizing the deleterious effects of pulmonary ischemia-reperfusion injury in heart surgery. Many renowned authors have contributed by presenting their expe- ence on lung perfusion in basic research and clinical trials. Furthermore, they have enlightened the quality of this textbook with new ideas, concepts, and future perspectives. The scope of this textbook is of interest to different professionals, such as card- vascular surgeons, pulmonary surgeons, transplantation physicians, cardiothoracic anesthesiologists, intensive care physicians, cardiothoracic fellows, radiologists, basic sciences physicians, cardiologists, pulmonary medicine physicians, perfusi- ists, nurses, students, and researchers. This textbook has 7 sections, aimed at addressing general and speci?c aspects of pulmonary protection during heart surgery with CPB. The ?rst section on general concepts provides information about anatomic, physiologic, histologic, molecular, and radiologic considerations regarding the lungs. The second section focuses on ischemia-reperfusion injury and is composed of several interesting chapters, addressing the basic science aspects of pulmonary p- tection, as well as experimental and clinical experiences from different heart surgery centers worldwide.
Contents
General Concepts.- Anatomy of the Lungs.- Respiratory Physiology.- Histological Features of Lungs.- Cellular and Molecular Aspects of Lung Function, its Control and Regulation.- Imaging Evaluation of the Thorax.- Ischemia-Reperfusion Injury.- Endothelial Protection During Heart Surgery and Lung Transplantation.- Vascular Endothelial Growth Factor and Pulmonary Injury.- Aprotinin Decreases Lung Reperfusion Injury and Dysfunction.- Effects of Prostaglandin E1 and Nitroglycerin on Lung Preservation.- Endothelin and Ischemia-Reperfusion Injury.- L-Arginine and Ischemia-Reperfusion Injury.- The Role of Nitric Oxide in Pulmonary Ischemia-Reperfusion Injury.- Activity of Glutathione-Related Enzymes in Ischemia and Reperfusion Injury.- Heart Histopathology in Ischemia-Reperfusion Injury.- Beating Heart Surgery and Pulmonary Ischemia and Reperfusion Injury.- Pulmonary Hypertension.- Mechanisms of Pulmonary Edema.- Idiopathic Pulmonary Hypertension: New Challenges.- Chronic Thromboembolic Pulmonary Hypertension and Pulmonary Endarterectomy.- Eisenmenger Syndrome.- Disseminated Intravascular Coagulation in Cardiac Surgery.- Pulmonary Arterial Hypertension.- Cardiopulmonary Bypass and Pulmonary Injury.- The Extracorporeal Circulation Circuit Versus Bioengineering Biomaterials.- Ischemic Preconditioning and Lung Preservation.- Impact of Cardiopulmonary Bypass on Pulmonary Hemodynamic Variables.- Impact of Cardiopulmonary Bypass on Gas Exchange Features.- Pulmonary Energy Metabolism and Multiple Inflammatory Repercussions.- Benefits of Ultrafiltration for Pulmonary Function.- Principles of Pulmonary Protection During Heart Surgery.- Lung Perfusion: Technique and Principles.- Determining Hemodynamic Parameters.- Extracorporeal Circuit Pathways for Lung Perfusion.- Hemodynamic Performance.- Quality of Gas Exchange.- Inflammatory Cell Markers.- Cytokines and Cellular Adhesion Molecules.- Macroscopical and Microscopical Findings.- Lung Perfusion: Issues and Controversies.- Continuous or Intermittent Lung Perfusion with Arterial or Venous Blood.- Lung Perfusion and Mechanical Ventilation.- Pulmonary Hemodynamic Profile and Natriuretic Peptides.- Low-Frequency Mechanical Ventilation During Cardiopulmonary Bypass.- Inhaled Carbon Monoxide as an Experimental Therapeutic Strategy of Lung Protection During Cardiopulmonary Bypass.- Lung Perfusion in Clinical Heart-Lung Surgery.- Lung Perfusion and Coronary Artery Bypass Grafting.- Lung Perfusion in Clinical Mitral Valve Surgery.- Lung Perfusion in Clinical Aortic Surgery.- Lung Perfusion in Clinical Heart-Lung Surgery: Congenital Heart Disease Surgery.- Retrograde Pulmonary Perfusion for Pulmonary Thromboembolism.- Lung Perfusion in Clinical Heart-Lung Transplantation.- Final Considerations.- Principles of Pulmonary Protection During Heart Surgery.- Lung Perfusion: Reflections and Perspectives.
