Series Cardiac Surgery

Hemoadsorption treatment of patients with acute infective endocarditis during surgery with cardiopulmonary bypass – A case series

Träger K, Skrabal C, Fischer G, Datzmann T, Schroeder J, Fritzler D, Hartmann J, Liebold A, Reinelt H
Int Art Organs J 2017; 40(5):240-9

In this retrospective case series, the authors describe 39 cardiac surgery patients with proven acute...

In this retrospective case series, the authors describe 39 cardiac surgery patients with proven acute infective endocarditis undergoing valve replacement during cardiopulmonary bypass surgery in combination with intraoperative CytoSorb hemoadsorption. In comparison an historical group of 28 similar patients treated without the use of intraoperative CytoSorb were evaluated. CytoSorb treatment was associated with a reduction in postoperative cytokines (IL6, IL8) and clinical metabolic parameters (lactate and base excess). Moreover, in comparison to the non-CytoSorb group, the CytoSorb patients showed hemodynamic stability (higher mean arterial pressure) during and after the operation with the need for vasopressors (norepinephrine and epinephrine) being lower within hours after completion of the procedure. The authors conclude that these improvements in patient outcome could be attributed to the use of the CytoSorb adsorber treatment and that its use is a potentially promising therapeutic option for this group of critically-ill patients leading to cytokine reduction, improved hemodynamic stability and organ function.

Treatment of post-cardiopulmonary bypass SIRS by hemoadsorption: a case series

Traeger K, Fritzler D, Fischer G, Schröder J, Skrabal C, Liebold A, Reinelt H
Int J Artif Organs 2017; 39(3):141-3

Objective of thiscase series in 16 adult patients undergoing standard or emergency cardiothoracic surgery procedures...

Objective of thiscase series in 16 adult patients undergoing standard or emergency cardiothoracic surgery procedures with prolonged CPB time, developing post-CPB SIRS over the course of the first post-operative 24 hours was to test the effect of CytoSorb on changes of inflammatory cytokines levels, metabolic parameters hemodynamic variables, and patient outcome. Treatment of these patients with CytoSorb in conjunction with CVVHD was associated with decreases in the proinflammatory cytokines, IL-6 and IL-8, as well as a clear stabilization of hemodynamic, metabolic and organ function parameters. All patients with an APACHE score of up to 30 survived. This is the first case series reporting the use of CytoSorb therapy in patients with post-CPB SIRS. Due to a modulation of the cytokine response, CytoSorb may offer a potentially promising new treatment option for severe post-CPB SIRS that presents with hemodynamic instability and requires high doses of vasopressors.

Systemic Inflammatory Response Syndrome in der Herzchirurgie: Neue Therapiemöglichkeiten durch den Einsatz eines Cytokin-Adsorbers während EKZ?

Born F, Pichlmaier M, Peter S, Khaladj N, Hagl C
Kardiotechnik 2/2014

In this retrospective observational study in 40 patients undergoing a major cardiosurgical procedure with the...

In this retrospective observational study in 40 patients undergoing a major cardiosurgical procedure with the application of a Cardio-Pulmonary-Bypass (CPB) (n=20 withCPB, n=20 with CPBand additionally implemented CytoSorb- adsorber into the circulation) the hypothesis was tested, whether the intraoperative treatment with CytoSorb has a positive effect on the developing post-operative SIRS. Results show, that CytoSorb contributes to a significant reduction of post-operative SIRS in those patients. This study further emphasizes the reliability and safety of CytoSorb also in the settingof cardio surgery.