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January 1963

Postperfusion Pulmonary Vasculitis: Its Relationship to Blood Trauma

Author Affiliations

Address as of July 1, 1962: Department of Surgery, Medical College of South Carolina, Charleston, S.C. (Dr. Clowes).; Present address: Department of Cardiopulmonary Surgery, Hines V.A. Hospital, Hines, Ill. (Dr. Neville).; From The Departments of Surgery and Pathology, Western Reserve University School of Medicine, at Cleveland Metropolitan General Hospital.

Arch Surg. 1963;86(1):126-137. doi:10.1001/archsurg.1963.01310070128017

A major cause of the morbidity after open heart surgery employing a pump oxygenator is pulmonary dysfunction. In the immediate postoperative period, more impairment of gas exchange is evident in the lungs of those patients in whom extracorporeal circulation is employed than is seen after cardiac surgery utilizing external hypothermia or closed intracardiac techniques. Apparently the perfusion aggravates the usual post-thoracotomy difficulties. Although many of the deleterious effects of the perfusion resulting in irreparable damage to the lungs have been alleviated through experience, postoperative pulmonary congestion still occurs. In view of this, it seems reasonable to assume that this pulmonary dysfunction is initiated during the period of cardiopulmonary bypass from changes in the milieu intérieur of the pulmonary capillaries, the alveolar membranes, or the lining of the bronchioles.7 At present it appears that the changes in the lung, as well as other circulatory abnormalities observed after total body perfusion,

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