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Haemoadsorption in infective endocarditis: a systematic review.

Matthias Thielmann1, Daniel-Sebastian Dohle2, Martin Czerny3

  • 1Department of Thoracic and Cardiovascular Surgery, West German Heart & Vascular Center Essen, Hufelandstr. 55, 45122 Essen, Germany.

Indian Journal of Thoracic and Cardiovascular Surgery
|June 3, 2024
PubMed
Summary

Intraoperative hemodialysis may help reduce complications in patients with infective endocarditis. This review examines the clinical effectiveness of this treatment for cardiac surgery patients with this serious infection.

Keywords:
Cardiac surgeryCytoSorb®HaemoadsorptionInfective endocarditis

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Area of Science:

  • Cardiovascular Surgery
  • Critical Care Medicine
  • Immunology

Background:

  • Infective endocarditis surgical patients face high mortality due to severe complications like systemic inflammatory response and septic shock.
  • Cytokine-mediated systemic inflammatory response is a key factor in the high morbidity and mortality of these patients.
  • Intraoperative hemodialysis is a proposed method to mitigate these risks by removing elevated cytokines.

Purpose of the Study:

  • To review the current literature on the clinical effectiveness of adjunctive intraoperative hemodialysis in patients undergoing cardiac surgery for infective endocarditis.
  • To assess the potential of hemodialysis to stabilize hemodynamics, reduce sepsis-related mortality, and protect organ function in this patient population.

Main Methods:

  • A systematic literature review was conducted.
  • The review focused on studies evaluating the use of intraoperative hemodialysis in infective endocarditis patients undergoing cardiac surgery.
  • The review was registered with PROSPERO (CRD42023457632).

Main Results:

  • The current literature lacks a general consensus on the clinical effectiveness of adjunctive intraoperative hemodialysis in infective endocarditis.
  • Further research is needed to establish the definitive role and benefits of this intervention.

Conclusions:

  • Adjunctive intraoperative hemodialysis is a promising strategy for managing severe complications in infective endocarditis surgery.
  • More high-quality clinical studies are required to confirm its efficacy and guide clinical practice.