Initial experience with CytoSorb therapy in patients receiving left ventricular assist devices

Konstantin Zhigalov; Jef Van den Eynde; Alina Zubarevich; Thomas Chrosch; Lukas Goerdt; Arian Arjomandi Rad; Robert Vardanyan; Michel Pompeu Barros Oliveira Sá; Peter Luedike; Nikolaus Pizanis; Achim Koch; Bastian Schmack; Markus Kamler; Arjang Ruhparwar; Alexander Weymann

doi:10.1111/aor.14099

Initial experience with CytoSorb therapy in patients receiving left ventricular assist devices

Konstantin Zhigalov, Jef Van den Eynde, Alina Zubarevich^*, Thomas Chrosch, Lukas Goerdt, Arian Arjomandi Rad, Robert Vardanyan, Michel Pompeu Barros Oliveira Sá, Peter Luedike, Nikolaus Pizanis, Achim Koch, Bastian Schmack, Markus Kamler, Arjang Ruhparwar, Alexander Weymann

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: The use of left ventricular assist devices (LVAD) in patients with advance heart failure is still associated with an important risk of immune dysregulation and infections. The aim of this study was to determine whether extracorporeal blood purification using the CytoSorb device benefits patients after LVAD implantation in terms of complications and overall survival.

MATERIALS AND METHODS: Between August 2010 and January 2020, 207 consecutive patients underwent LVAD implantation, of whom 72 underwent CytoSorb therapy and 135 did not. Overall survival, major adverse events, and laboratory parameters were compared between 112 propensity score-matched patients (CytoSorb: 72 patients; non-CytoSorb: 40 patients).

RESULTS: WBC (p = .033), CRP (p = .001), and IL-6 (p < .001), significantly increased with LVAD implantation, while CytoSorb did not influence this response. In-hospital mortality and overall survival during follow-up were similar with CytoSorb. However, patients treated with CytoSorb were more likely to develop respiratory failure (54.2% vs. 30.0%, p = .024), need mechanical ventilation for longer than 6 days post-implant (50.0% vs. 27.5%, p = .035), and require tracheostomy during hospitalization (31.9% vs. 12.5%, p = .040). No other significant differences were observed with regard to major adverse events during follow-up.

CONCLUSIONS: Overall, our results showed that CytoSorb might not convey a significant morbidity or mortality benefit for patients undergoing LVAD implantation.

Original language	English
Pages (from-to)	95-105
Number of pages	11
Journal	Artificial Organs
Volume	46
Issue number	1
DOIs	https://doi.org/10.1111/aor.14099
Publication status	Published - Jan 2022
Externally published	Yes

Keywords

C-Reactive Protein/analysis
Female
Heart Failure/therapy
Heart-Assist Devices/adverse effects
Hemofiltration/instrumentation
Hospital Mortality
Humans
Interleukin-6/blood
Leukocyte Count
Male
Middle Aged
Respiration, Artificial/statistics & numerical data
Respiratory Insufficiency
Retrospective Studies
Tracheotomy/statistics & numerical data
Treatment Outcome

Access to Document

10.1111/aor.14099Licence: CC BY-NC-ND

Cite this

Zhigalov, K., Van den Eynde, J., Zubarevich, A., Chrosch, T., Goerdt, L., Arjomandi Rad, A., Vardanyan, R., Sá, M. P. B. O., Luedike, P., Pizanis, N., Koch, A., Schmack, B., Kamler, M., Ruhparwar, A., & Weymann, A. (2022). Initial experience with CytoSorb therapy in patients receiving left ventricular assist devices. Artificial Organs, 46(1), 95-105. https://doi.org/10.1111/aor.14099

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title = "Initial experience with CytoSorb therapy in patients receiving left ventricular assist devices",

abstract = "BACKGROUND: The use of left ventricular assist devices (LVAD) in patients with advance heart failure is still associated with an important risk of immune dysregulation and infections. The aim of this study was to determine whether extracorporeal blood purification using the CytoSorb device benefits patients after LVAD implantation in terms of complications and overall survival.MATERIALS AND METHODS: Between August 2010 and January 2020, 207 consecutive patients underwent LVAD implantation, of whom 72 underwent CytoSorb therapy and 135 did not. Overall survival, major adverse events, and laboratory parameters were compared between 112 propensity score-matched patients (CytoSorb: 72 patients; non-CytoSorb: 40 patients).RESULTS: WBC (p = .033), CRP (p = .001), and IL-6 (p < .001), significantly increased with LVAD implantation, while CytoSorb did not influence this response. In-hospital mortality and overall survival during follow-up were similar with CytoSorb. However, patients treated with CytoSorb were more likely to develop respiratory failure (54.2% vs. 30.0%, p = .024), need mechanical ventilation for longer than 6 days post-implant (50.0% vs. 27.5%, p = .035), and require tracheostomy during hospitalization (31.9% vs. 12.5%, p = .040). No other significant differences were observed with regard to major adverse events during follow-up.CONCLUSIONS: Overall, our results showed that CytoSorb might not convey a significant morbidity or mortality benefit for patients undergoing LVAD implantation.",

keywords = "C-Reactive Protein/analysis, Female, Heart Failure/therapy, Heart-Assist Devices/adverse effects, Hemofiltration/instrumentation, Hospital Mortality, Humans, Interleukin-6/blood, Leukocyte Count, Male, Middle Aged, Respiration, Artificial/statistics & numerical data, Respiratory Insufficiency, Retrospective Studies, Tracheotomy/statistics & numerical data, Treatment Outcome",

author = "Konstantin Zhigalov and {Van den Eynde}, Jef and Alina Zubarevich and Thomas Chrosch and Lukas Goerdt and {Arjomandi Rad}, Arian and Robert Vardanyan and S{\'a}, {Michel Pompeu Barros Oliveira} and Peter Luedike and Nikolaus Pizanis and Achim Koch and Bastian Schmack and Markus Kamler and Arjang Ruhparwar and Alexander Weymann",

note = "{\textcopyright} 2021 The Authors. Artificial Organs published by International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.",

year = "2022",

month = jan,

doi = "10.1111/aor.14099",

language = "English",

volume = "46",

pages = "95--105",

journal = "Artificial Organs",

issn = "0160-564X",

publisher = "Wiley",

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Zhigalov, K, Van den Eynde, J, Zubarevich, A, Chrosch, T, Goerdt, L, Arjomandi Rad, A, Vardanyan, R, Sá, MPBO, Luedike, P, Pizanis, N, Koch, A, Schmack, B, Kamler, M, Ruhparwar, A & Weymann, A 2022, 'Initial experience with CytoSorb therapy in patients receiving left ventricular assist devices', Artificial Organs, vol. 46, no. 1, pp. 95-105. https://doi.org/10.1111/aor.14099

TY - JOUR

T1 - Initial experience with CytoSorb therapy in patients receiving left ventricular assist devices

AU - Zhigalov, Konstantin

AU - Van den Eynde, Jef

AU - Zubarevich, Alina

AU - Chrosch, Thomas

AU - Goerdt, Lukas

AU - Arjomandi Rad, Arian

AU - Vardanyan, Robert

AU - Sá, Michel Pompeu Barros Oliveira

AU - Luedike, Peter

AU - Pizanis, Nikolaus

AU - Koch, Achim

AU - Schmack, Bastian

AU - Kamler, Markus

AU - Ruhparwar, Arjang

AU - Weymann, Alexander

PY - 2022/1

Y1 - 2022/1

N2 - BACKGROUND: The use of left ventricular assist devices (LVAD) in patients with advance heart failure is still associated with an important risk of immune dysregulation and infections. The aim of this study was to determine whether extracorporeal blood purification using the CytoSorb device benefits patients after LVAD implantation in terms of complications and overall survival.MATERIALS AND METHODS: Between August 2010 and January 2020, 207 consecutive patients underwent LVAD implantation, of whom 72 underwent CytoSorb therapy and 135 did not. Overall survival, major adverse events, and laboratory parameters were compared between 112 propensity score-matched patients (CytoSorb: 72 patients; non-CytoSorb: 40 patients).RESULTS: WBC (p = .033), CRP (p = .001), and IL-6 (p < .001), significantly increased with LVAD implantation, while CytoSorb did not influence this response. In-hospital mortality and overall survival during follow-up were similar with CytoSorb. However, patients treated with CytoSorb were more likely to develop respiratory failure (54.2% vs. 30.0%, p = .024), need mechanical ventilation for longer than 6 days post-implant (50.0% vs. 27.5%, p = .035), and require tracheostomy during hospitalization (31.9% vs. 12.5%, p = .040). No other significant differences were observed with regard to major adverse events during follow-up.CONCLUSIONS: Overall, our results showed that CytoSorb might not convey a significant morbidity or mortality benefit for patients undergoing LVAD implantation.

AB - BACKGROUND: The use of left ventricular assist devices (LVAD) in patients with advance heart failure is still associated with an important risk of immune dysregulation and infections. The aim of this study was to determine whether extracorporeal blood purification using the CytoSorb device benefits patients after LVAD implantation in terms of complications and overall survival.MATERIALS AND METHODS: Between August 2010 and January 2020, 207 consecutive patients underwent LVAD implantation, of whom 72 underwent CytoSorb therapy and 135 did not. Overall survival, major adverse events, and laboratory parameters were compared between 112 propensity score-matched patients (CytoSorb: 72 patients; non-CytoSorb: 40 patients).RESULTS: WBC (p = .033), CRP (p = .001), and IL-6 (p < .001), significantly increased with LVAD implantation, while CytoSorb did not influence this response. In-hospital mortality and overall survival during follow-up were similar with CytoSorb. However, patients treated with CytoSorb were more likely to develop respiratory failure (54.2% vs. 30.0%, p = .024), need mechanical ventilation for longer than 6 days post-implant (50.0% vs. 27.5%, p = .035), and require tracheostomy during hospitalization (31.9% vs. 12.5%, p = .040). No other significant differences were observed with regard to major adverse events during follow-up.CONCLUSIONS: Overall, our results showed that CytoSorb might not convey a significant morbidity or mortality benefit for patients undergoing LVAD implantation.

KW - C-Reactive Protein/analysis

KW - Female

KW - Heart Failure/therapy

KW - Heart-Assist Devices/adverse effects

KW - Hemofiltration/instrumentation

KW - Hospital Mortality

KW - Humans

KW - Interleukin-6/blood

KW - Leukocyte Count

KW - Male

KW - Middle Aged

KW - Respiration, Artificial/statistics & numerical data

KW - Respiratory Insufficiency

KW - Retrospective Studies

KW - Tracheotomy/statistics & numerical data

KW - Treatment Outcome

U2 - 10.1111/aor.14099

DO - 10.1111/aor.14099

M3 - Article

C2 - 34694644

SN - 0160-564X

VL - 46

SP - 95

EP - 105

JO - Artificial Organs

JF - Artificial Organs

IS - 1

ER -