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Immune system 

Immune system
Chapter:
Immune system
Author(s):

Mike Higgins

DOI:
10.1093/med/9780199692958.003.0016
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date: 15 September 2019

Major surgery triggers a systemic inflammatory response. This is particularly so in cases involving cardiopulmonary bypass due to the exposure of the blood to the artificial surface. Biochemical and physiological signs of this response may be found in all post-cardiac surgery patients if one investigates carefully enough; however, it is clinically apparent in only a proportion and problematic in a minority. The systemic inflammatory response syndrome (SIRS) associated with major surgery is clinically indistinguishable from that triggered by infection (SIRS associated with infection is called sepsis). Clinical features potentially include vasodilatation and hypotension, capillary leak, delirium, renal dysfunction, and increased susceptibility to infection. The diagnosis, investigation, and management of heparin-induced thrombocytosis (HIT) are reviewed.

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