在感染性内心炎的门手术中使用CytoSorb® Hemoadsorption进行体外血液净化:一系列病例
Živojin S Jonjev1,2, Anđela Božić3, Ilija Bjeljac3
1Clinic of Cardiovascular Surgery, Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.
The American journal of case reports
|September 15, 2025
概括
这一案例系列表明,用CytoSorb进行手术内血吸可能有利于因感染性内心炎 (IE) 接受手术的患者. 它有助于减少炎症并改善严重IE病例的恢复.
科学领域:
- 心脏病学 心脏病学
- 临界护理医学 临界护理医学
- 手术创新 在外科创新.
背景情况:
- 传染性内心炎 (IE) 由于感染和全身炎症而带来显著的死亡风险.
- 目前治疗严重的IE,特别是在心脏手术期间,对于高危人群来说,其结果并不理想.
- 血液吸附被探索作为一个辅助在心肺旁路 (CPB) 期间减少炎症.
研究的目的:
- 评估使用CytoSorb装置在接受紧急心脏手术的严重传染性内心炎患者中进行手术内吸血的潜在益处.
- 评估CytoSorb血液吸收对炎症标志物的影响,血液动力学稳定性和IE患者的术后恢复.
主要方法:
- 一个由4名已成年患者组成的病例系列,确认了细菌性IE,需要紧急的心脏手术.
- 在手术期间将CytoSorb血吸血吸收集成到心肺旁路电路中.
- 监测炎症标志物,乳酸,血管压缩剂的需求,以及术后机械通风的持续时间.
主要成果:
- 在手术后24小时内,炎症标志物 (CRP,prokalcitonin),乳酸和血管压缩剂需求显著减少.
- 与机构平均值相比,机械通风持续时间更短.
- 没有患者需要重新手术,机械循环支持或术后血吸;所有人都在7-17天之间出院,没有6个月的并发症.
结论:
- 用CytoSorb进行手术内血吸附可能是重症IE手术治疗的有益补充,特别是在炎症负担高的患者中.
- 观察到血液动力学稳定性,炎症反应和术后恢复的改善.
- 需要进一步的随机对照试验来确认疗效并确定患者选择标准.
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