Complications of CPB

Complications of CPB

CPB is a complex technique requiring careful interaction and communication between surgeon, anaesthetist and perfusionist to ensure patient safety . Di ffi culties can occur during cannu lation (aortic dissection or atrial injury), at the start of CPB (oxygenator failure) and at the end of CPB (coagulopathy). Other complications can occur following blood exposur e to the non-physiological surface of the CPB circuit. This leads to the William Dressler , 1890–1969, cardiologist and Director of Cardiology at Maimonides Medical Center, Brooklyn, NY , USA. rise to a post-CPB systemic inflammatory response syndrome (SIRS) that can lead to multiorgan failure. Recent improved under standing of the impact of CPB on coagulation and the inflammatory response (SIRS) has resulted in the development of smaller ‘mini’ CPB circuits, which have demonstrated some advantages in ter ms of reduced post-CPB inflammatory responses and blood transfusion requirements. Alternative methods include surgery ‘o ff -pump’ on a beating heart without the use of CPB; this has some advantages but its use remains restricted to coronary artery bypass grafting (CABG).