Intraoperative Hemoadsorption (Cytosorb (TM)) during Open Thoracoabdominal Aortic Repair: A Pilot Randomized Controlled Trial

P. Doukas*, G. Hellfritsch, D. Wendt, M. Magliani, M.E. Barbati, H. Jalaie, M.J. Jacobs, A. Gombert

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: The efficacy of cytokine adsorption in controlling the early inflammation cascade after open thoracoabdominal aortic (TAAA) repair has not been investigated. The aim of this pilot randomized controlled trial was to assess the feasibility and effect of perioperative hemoadsorption during open TAAA repair. Methods: Patients scheduled for open TAAA repair with the use of cardiopulmonary bypass (CPB) were included. The patients were randomized the day before surgery to either intraoperative hemoadsorption during CPB or standard of care. Results: A total of 10 patients were randomly assigned to the intervention group, whereas the control group consisted of 17 patients (mean age of the total cohort, 51.1 +/- 11.2 years, 67% male, 3 patients not randomized). The majority of baseline and perioperative characteristics were similar, and no device-related adverse events were reported. A trend to shorter ventilation times in the intervention group was observed (median 88 h vs. 510 h, p = 0.08, Delta 422). Severe acute respiratory distress syndrome was significantly less in the intervention patients (p = 0.02). Conclusions: This is the first pilot study showing that the intraoperative use of hemoadsorption in open TAAA repair patients may be feasible and safe, yet larger trials are needed to evaluate whether intraoperative hemoadsorption is associated with improved clinical outcomes.
Original languageEnglish
Article number546
Number of pages10
JournalJournal of Clinical Medicine
Volume12
Issue number2
DOIs
Publication statusPublished - 1 Jan 2023
Externally publishedYes

Keywords

  • aortic surgery
  • hemoadsorption
  • cardiopulmonary bypass
  • inflammation
  • SYSTEMIC INFLAMMATION
  • SEPTIC SHOCK
  • MANAGEMENT
  • SURGERY
  • INJURY

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