Cardiopulmonary bypass technologies - Biomaterials and Devices for the Circulatory System - page 164

be balanced and not subject the patient to increased risk of infection and
wound complications. Ultimately we need to gain a better understanding
of the infl ammatory response including the pre-existing triggers. Therefore,
a combination of different therapeutic modalities to interrupt infl ammatory
response would likely be more effective than a single treatment.
We do not believe novel challenges and controversies against CPB will
be suffi ciently successful to create an absolute alternative in the near future.
Each has a long way to go and cost effectiveness will be the fi rst problem
to overcome. Novel applications of CPB may also broaden the fi eld of
application. We need to focus our research efforts to better understand and
stratify patients' biologic profi les before choosing a specifi c treatment strat-
egy. This may avoid the current relatively crude, blind and potentially
expensive, broad and unfocused application of mechanical, technical, and
pharmacological approaches to a biologically diverse patient population.
The future of cardiac surgery will be marked by an increasingly complex,
high-risk group of patients and a greater need for multiple modalities for
reducing bleeding or overcoming infl ammatory response.

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