Endotoxin release in cardiac surgery with cardiopulmonary bypass: pathophysiology and possible therapeutic strategies. An update

Suzanne Kats*, Jacques P. A. M. Schonberger, Ruud Brands, Willem Seinen, Wim van Oeveren

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Cardiac surgery with cardiopulmonary bypass provokes a systemic inflammatory response syndrome caused by the surgical trauma itself, blood contact with the non-physiological surfaces of the extracorporeal circuit, endotoxemia, and ischemia. The role of endotoxin in the inflammatory response syndrome has been well investigated. In this report, we reviewed recent advances in the understanding of the pathophysiology of the endotoxin release during cardiopulmonary bypass and the possible therapeutic strategies aimed to reduce the endotoxin release or to counteract the inflammatory effects of endotoxin. Although many different strategies to detoxify endotoxins were evaluated, none of them were able to show statistically significant differences in clinical outcome. European Association for Cardio-Thoracic Surgery. Published by
Original languageEnglish
Pages (from-to)451-458
JournalEuropean Journal of Cardio-Thoracic Surgery
Issue number4
Publication statusPublished - Apr 2011


  • Endotoxin release
  • Cardiopulmonary bypass
  • Inflammatory response syndrome

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