Cardiopulmonary Bypass Circuit and the Brain

Credit for the development of modern day cardiopulmonary bypass (CPB) is usually given to John Gibbons, who produced a functional heart-lung machine at the Mayo Clinic in the early 1950s.¹ The development of the CPB circuit and the field of perfusion in general have been instrumental in the advancement of cardiac surgery over the last 5 decades. However, important neurologic complications were described shortly after the widespread adoption of CPB.^2,3 Such central nervous system complications range from subclinical cognitive dysfunction to delirium, to focal stroke, to coma and/or death. An ever-increasing number of clinical and basic research investigations have focused on the impact of CPB on neurologic complications since the 1980s.^4-12