New on PubMed
Hemoadsorption in Complex Cardiac Surgery-A Single Center Experience
Murali Manohar et al. J Clin Med. 2022.
Hide details
J Clin Med
. 2022 Nov 27;11(23):7005.
doi: 10.3390/jcm11237005.
Authors
Murali Manohar 1 , Vivek Jawali 1 2 , Siddu Neginahal 3 , Sudarshan Gt 1 , Geetha Muniraj 4 , Murali Chakravarthy 4
Affiliations
1 Cardiac Surgery Department, Fortis Hospital, Bengaluru 560076, India.
2 Cardiac Sciences Board, Fortis Hospital, Bengaluru 560076, India.
3 Cardiac Surgery Perfusion Department, Fortis Hospital, Bengaluru 560076, India.
4 Anaesthesia Department, Fortis Hospital, Bengaluru 560076, India.
PMID: 36498579
DOI: 10.3390/jcm11237005
Cite
Abstract
(1) Background: Cardiac surgery may evoke a generalized inflammatory response, typically magnified in complex, combined, redo, and emergency procedures with long aortic cross-clamp times. Various treatment options have been introduced to help regain control over post-cardiac surgery hyper-inflammation, including hemoadsorptive immunomodulation with CytoSorb®. (2) Methods: We conducted a single-center retrospective observational study of patients undergoing complex cardiac surgery. Patients intra-operatively treated with CytoSorb® were compared to a control group. The primary outcome was the change in the vasoactive-inotropic score (VIS) from pre-operatively to post-operatively. (3) Results: A total of 52 patients were included in the analysis, where 23 were treated with CytoSorb® (CS) and 29 without (controls). The mean VIS increase from pre-operative to post-operative values was significantly lower in the CS group compared to the control group (3.5 vs. 5.5, respectively, p = 0.05). In-hospital mortality in the control group was 20.7% (6 patients) and 9.1% (2 patients) in the CS group (p = 0.26). Lactate level changes were comparable, and the median intensive care unit and hospital lengths of stay were similar between groups. (4) Conclusions: Despite notable imbalances between the groups, the signals revealed point toward better hemodynamic stability with CytoSorb® hemoadsorption in complex cardiac surgery and a trend of lower mortality.
Keywords: aortic surgery; blood purification; complex cardiac surgery; cytokines; cytosorb; hemoadsorption; hyperinflammation; redo.
