What are the effects of CPB on the lungs, the brain, and the kidneys?

What are the effects of CPB on the lungs, the brain, and the kidneys?

CPB causes a total body inflammatory reaction that results in the release of vasoactive substances, cytokine medi-ators, and endotoxins into the bloodstream. All major organs are affected and the degree of the response is dependent on the length of CPB, the extent of tissue trauma, and patient genetic factors. As a result, major organs such as the lungs, brain, and kidneys suffer. Factors that lead to organ dysfunction include edema, reduced perfusion, and nonpul-satile perfusion. Mild renal dysfunction is common after CPB and is often reversible. The lungs are often dysfunctional after CPB due to atelectasis and inflammation. The brain suffers similar effects in that edema and reduced perfusion may occur. However, the brain suffers additional potential insults during CPB. Cerebral dysfunction is the major morbidity that occurs after cardiac surgery. Most of this dysfunction is the result of atheroemboli that dislodge from the aorta during procedures such as aortic cross-clamping, cannula-tion, and proximal vein graft anastomosis. Some of these atheroemboli can be seen using epiaortic ultrasound before cannulation of the aorta. However, the majority of cerebral dysfunction probably results from microemboli that can be neither detected nor prevented. A large portion of the neuropsychological dysfunction seen after CPB resolves within the first year after surgery.