Systemic hyperinflammation in cardiac surgery patients
Cardiac Surgery procedures using cardiopulmonary bypass (CPB) may result in activation of the complement system and stimulation of inflammatory cytokine production due to factors such as the trauma of surgery, non-pulsatile blood flow, ischemic-reperfusion injury, and blood contact with air and the foreign surfaces of the CPB system.
Despite significant advances in surgical techniques and perfusion technologies, patients at already high risk or undergoing complex cardiac surgery procedures still have a significantly high chance of complications.
This could happen since the activation of various mediators of inflammation, such as cytokines, may lead to postoperative systemic hyperinflammation with associated complications such as vasoplegia, acute renal failure, respiratory and circulatory failure.
CytoSorb therapy*, by removing excessive levels of cytokines, may be a solution with the potential to reduce post-operative complications in patients undergoing cardiac surgery.
Cardiac surgery patients with a high risk profile or patients who have to undergo long, complicated procedures were shown in clinical studies to particularly benefit from the intra-operative application of CytoSorb for:
- Endocarditis with valve surgeries1
- Aortic dissection2
- Heart transplant3
- Complex combined and/or redo procedures4
To date CytoSorb has been safely used intra-operatively in heart-lung machines during several thousand heart surgeries.
CytoSorb has also been used several thousand times post-operatively, to control the systemic hyperinflammatory state, occuring as a result of cardiac surgery.
This flexibility in the usage of CytoSorb may allow the use in a wide variety of cardiac surgery patients who are either at high risk (intraoperative use) or who have already developed postoperative hyperinflammatory complications (postoperative use), as reported in several clinical studies.
It was observed in clinical studies that CytoSorb Therapy, when used as intended, can help in the cardiac surgery setting due to the following positive potential effects:
- Effective reduction of excessive cytokines and activated complement system5
- Improvement in hemodynamics (macro- and micro-circulation) with reduced need for vasopressors6
- Reduction of free hemoglobin7
- Reduction in post-operative sepsis in Infective Endocarditis patients1
1) Haidari Z et al., Ann Thorac Surg. Sep 2020;110(3):890-896
2) Saller T, et al., Eur J Cardiothorac Surg. 2019 Oct 1;56(4):731-737
3) Nemeth E, et al., Clinical Transplantation. 2018 Apr;32(4):e13211
4) Mehta Y, et al., J Cardiothorac Vasc Anesth. 2021 Feb;35(2):673-675
5) Träger K et al., Int J Artif Organs. 2020 Jun;43(6):422-429
6) Calabrò MG et al., Artif Organs 2019_ 43(2): 189-194
7) Gleason TG, Semin Thorac Cardiovasc Surg Winter 2019;31(4):783-793