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Hemoadsorption in Complex Cardiac Surgery—A Single Center Experience

(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-inflammati...

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Autores principales: Manohar, Murali, Jawali, Vivek, Neginahal, Siddu, GT, Sudarshan, Muniraj, Geetha, Chakravarthy, Murali
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9735704/
https://www.ncbi.nlm.nih.gov/pubmed/36498579
http://dx.doi.org/10.3390/jcm11237005
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author Manohar, Murali
Jawali, Vivek
Neginahal, Siddu
GT, Sudarshan
Muniraj, Geetha
Chakravarthy, Murali
author_facet Manohar, Murali
Jawali, Vivek
Neginahal, Siddu
GT, Sudarshan
Muniraj, Geetha
Chakravarthy, Murali
author_sort Manohar, Murali
collection PubMed
description (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.
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spelling pubmed-97357042022-12-11 Hemoadsorption in Complex Cardiac Surgery—A Single Center Experience Manohar, Murali Jawali, Vivek Neginahal, Siddu GT, Sudarshan Muniraj, Geetha Chakravarthy, Murali J Clin Med Article (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. MDPI 2022-11-27 /pmc/articles/PMC9735704/ /pubmed/36498579 http://dx.doi.org/10.3390/jcm11237005 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Manohar, Murali
Jawali, Vivek
Neginahal, Siddu
GT, Sudarshan
Muniraj, Geetha
Chakravarthy, Murali
Hemoadsorption in Complex Cardiac Surgery—A Single Center Experience
title Hemoadsorption in Complex Cardiac Surgery—A Single Center Experience
title_full Hemoadsorption in Complex Cardiac Surgery—A Single Center Experience
title_fullStr Hemoadsorption in Complex Cardiac Surgery—A Single Center Experience
title_full_unstemmed Hemoadsorption in Complex Cardiac Surgery—A Single Center Experience
title_short Hemoadsorption in Complex Cardiac Surgery—A Single Center Experience
title_sort hemoadsorption in complex cardiac surgery—a single center experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9735704/
https://www.ncbi.nlm.nih.gov/pubmed/36498579
http://dx.doi.org/10.3390/jcm11237005
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