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Hemoadsorption in Complex Cardiac Surgery-A Single Center Experience.

Murali Manohar1, Vivek Jawali1,2, Siddu Neginahal3

  • 1Cardiac Surgery Department, Fortis Hospital, Bengaluru 560076, India.

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Summary

CytoSorb hemoadsorption may improve hemodynamic stability in complex cardiac surgery patients. This treatment showed a trend toward lower mortality and reduced the increase in vasoactive-inotropic score post-operatively.

Keywords:
aortic surgeryblood purificationcomplex cardiac surgerycytokinescytosorbhemoadsorptionhyperinflammationredo

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Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Surgical Innovation

Background:

  • Cardiac surgery can trigger significant inflammatory responses, especially in complex procedures.
  • Hyper-inflammation post-cardiac surgery presents a challenge, with treatments like CytoSorb aiming to mitigate this.
  • CytoSorb is a hemoadsorptive immunomodulation therapy used to manage post-cardiac surgery inflammation.

Purpose of the Study:

  • To evaluate the effectiveness of CytoSorb hemoadsorption in complex cardiac surgery.
  • To assess the impact of CytoSorb on hemodynamic stability, measured by the vasoactive-inotropic score (VIS).
  • To compare in-hospital mortality and other clinical outcomes between patients treated with and without CytoSorb.

Main Methods:

  • A single-center retrospective observational study design was employed.
  • Patients undergoing complex cardiac surgery were divided into two groups: those treated with CytoSorb intra-operatively and a control group.
  • The primary outcome measured was the change in the vasoactive-inotropic score (VIS) from pre-operative to post-operative periods.

Main Results:

  • The mean increase in VIS was significantly lower in the CytoSorb group (3.5) compared to the control group (5.5), p=0.05.
  • In-hospital mortality was 9.1% in the CytoSorb group versus 20.7% in the control group (p=0.26).
  • Changes in lactate levels and lengths of intensive care unit and hospital stays were similar between the groups.

Conclusions:

  • CytoSorb hemoadsorption demonstrated potential for improving hemodynamic stability in complex cardiac surgery.
  • A trend towards reduced in-hospital mortality was observed in patients treated with CytoSorb.
  • Despite group imbalances, findings suggest CytoSorb may be beneficial in managing post-cardiac surgery inflammation and instability.