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Cytokine Hemoadsorption versus Standard Care in Cardiac Surgery Using the Oxiris Membrane: The OXICARD Single-center
Osama Abou-Arab1, Pierre Huette2, Azrat Ibrahima2
1Anesthesia and Critical Care Department, Amiens University Hospital, Amiens, France; EA7517, Pathophysiological Mechanisms and Consequences of Cardiovascular Calcifications (MP3CV), Jules Verne University of Picardie, Amiens, France.
Anesthesiology
|January 22, 2025
Summary
Hemadsorption with the Oxiris membrane did not improve microcirculation or reduce adverse cardiovascular events in high-risk cardiac surgery patients. Further research is needed to explore its potential benefits in specific inflammatory conditions.
Area of Science:
- Cardiology
- Critical Care Medicine
- Biomaterials Science
Background:
- Cardiac surgery can induce a proinflammatory state, leading to adverse outcomes.
- The Oxiris membrane (AN-69) possesses properties to chelate inflammatory cytokines.
- This study investigated the Oxiris membrane's potential to mitigate inflammation and improve outcomes in high-risk cardiac surgery.
Purpose of the Study:
- To evaluate the efficacy of the Oxiris membrane in reducing inflammation during cardiac surgery.
- To assess the impact of Oxiris membrane use on endothelial function and microcirculation.
- To determine if Oxiris membrane treatment improves postoperative outcomes in high-risk patients.
Main Methods:
- A randomized single-center study involving adult patients undergoing scheduled cardiac surgery with expected cardiopulmonary bypass (CPB) >90 minutes.
- Patients were assigned to either a standard group or an Oxiris group, with the intervention group receiving Oxiris membrane treatment during CPB.
- Primary outcome: sublingual microcirculation assessed by microvascular flow index (MFI) on postoperative day 1. Secondary outcome: composite adverse events within 30 days.
Main Results:
- No significant difference in microvascular flow index was observed between the Oxiris and standard groups on postoperative day 1 (P=0.2).
- The incidence of composite adverse outcomes within 30 days did not differ significantly between the groups (42% vs. 35%, P=0.7).
- No significant differences were found in the variation of cytokines and angiopoietins between the groups.
Conclusions:
- The use of the Oxiris membrane during prolonged CPB in cardiac surgery did not demonstrate a benefit in improving microcirculation.
- The study failed to show a significant reduction in major cardiovascular events with Oxiris membrane treatment.
- Further investigation is warranted to identify specific patient populations or conditions where Oxiris membrane hemadsorption may offer clinical advantages.
