Hemadsorption in patients requiring <scp>V‐A ECMO</scp> support: Comparison of Cytosorb versus Jafron <scp>HA330</scp>

Lesbekov, Timur; Nurmykhametova, Zhuldyz; Kaliyev, Rymbay; Kuanyshbek, Aidyn; Faizov, Linar; Bekishev, Bolat; Jabayeva, Nilufar; Samalavičius, Robertas; Pya, Yuriy

doi:10.1111/aor.14457

Cited by 6 publications

(7 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Table 1 (Ref. [ 14 , 15 , 16 , 19 , 20 , 21 ]) provides the details of the included studies. The included studies were published in the year 2022, one study presented a randomized population [ 22 ] and the others were observational cohort studies.…”

Section: Resultsmentioning

confidence: 99%

“…Although there are several studies on the use of Cy-tosorb® in the context of v.a. ECMO therapy or LVAD implantation in patients with heart failure, their results have been inconsistent [14,15]. Another hemoadsorbtion device (e.g., HA380, Jafron, Zhuhai City, Guangdong, China) has been also designed aiming at reducing the systemic inflammatory response and improving postoperative recovery [16], however its use in patients with heart failure has been limited so far.…”

Section: Introductionmentioning

confidence: 99%

“…Although there are several studies on the use of Cytosorb® in the context of v.a. ECMO therapy or LVAD implantation in patients with heart failure, their results have been inconsistent [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Hemoadsorption in Heart Failure Requiring Mechanical Circulatory Support—A Systematic Review and Meta-Analysis

Freiburger¹,

Caldonazo²,

Tasoudis³

et al. 2023

Rev. Cardiovasc. Med.

View full text Add to dashboard Cite

Background: Left ventricular assist devices (LVAD) and extracorporeal membrane oxygenation (ECMO) are well established therapies in heart failure (HF) management. Their use is generally associated with a sudden increase in inflammatory mediators, which are often already elevated in patients with HF prior to device implantation. An exaggerated release of proinflammatory cytokines is associated with organ dysfunction and increased mortality. Hemoadsorption has been shown to reduce inflammatory mediators during cardiopulmonary bypass. Objective: To investigate the role of hemoadsorption during the management of acute or chronic heart failure with mechanical circulatory support and its impact on survival. Methods: We systematically searched MEDLINE selecting all studies comparing the use of hemoadsorption during LVAD implantation or veno-arterial (v.a.) ECMO therapy. Records were screened by two different investigators. Reports without a control group and duplicates were excluded. Results: Our search delivered six studies. One was randomized and five were retrospective studies, of which three were risk-adjusted. During LVAD implantation, one study showed no difference in mortality but higher incidence of respiratory insufficiency in the hemoadsorption group (54% vs 30%, p = 0.024) and the other study found higher mortality in the hemoadsorption group (33% vs 0%, p = 0.01). During ECMO therapy, three of four studies including the randomized one found no difference in survival or major adverse cardiac events between the hemoadsorption and the control groups. Only one study found lower mortality in the hemoadsorption group (20% vs 60%. p = 0.02). Conclusions: The results of this literature review suggest that the use of hemoadsorption in patients undergoing LVAD implantation might be associated with higher morbidity and mortality. The majority of studies on the use of hemoadsorption during v.a. ECMO therapy showed no effect on mortality or organ dysfunction, while only one small study showed that hemoadsorption was able to reduce mortality. The results are limited by the retrospective nature and the small sample sizes of the majority of the studies included.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Hemoadsorption in Heart Failure Requiring Mechanical Circulatory Support—A Systematic Review and Meta-Analysis

Freiburger¹,

Caldonazo²,

Tasoudis³

et al. 2023

Rev. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…Additionally, it was observed that the mortality rate in the control group was higher compared to the cytokine adsorption groups (60% vs. 20%, p = 0.02). After a 72-hour period in intensive care, there was a noticeable decrease in blood in ammation markers 17 . Additionally, a comprehensive review of the relevant literature has consistently shown an increasing use of hemoadsorption in patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR).…”

Section: Discussionmentioning

confidence: 99%

Cytokine adsorption in patients with cardiac arrest receiving extracorporeal cardiopulmonary resuscitation (CAECR): a randomized controlled clinical trial protocol

Chen,

Zhou,

Yang

et al. 2023

Preprint

View full text Add to dashboard Cite

Introduction : Even after the introduction of extracorporeal cardiopulmonary resuscitation (ECPR), clinical prognosis following cardiac arrest (CA) remains poor. Post-cardiac arrest syndrome (PCAS) may contribute to cardiovascular instability and death after ECPR. Systemic inflammation constitutes is a significant component of PCAS, and the severity of PCAS is associated with the levels of inflammatory cytokines. Preliminary investigations supported further assessments of cytokine adsorption as adjunctive therapy for patients with Acute Respiratory Distress Syndrome (ARDS) and septic shock. This study aims to investigate whether cytokine adsorption can shorten the duration of Vein-Artery Extracorporeal Membrane Oxygenation (VA-ECMO) therapy in ECPR patients. Methods and analysis: The CAECR trial will be a single-center, randomized controlled, open-label trial. Patients will be randomized into two balanced parallel groups in a 1:1 ratio at the onset of ECMO initiation. Patients in the control group will undergo ECPR and receive standardized care, while those in the intervention group will undergo cytokine adsorption in addition to ECPR and receive standardized care. A 2-1-1 protocol will be adopted for cytokine adsorption: two units will be used for 12 h in the first 24 h, and then one unit per day for 24 h in the following 2 days. The primary outcome will be the duration of VA-ECMO therapy. The secondary outcomes will include related inflammatory markers, coagulation parameters, hemodynamic parameters, respiratory mechanics parameters, mechanical ventilation(MV) time, continuous renal replacement therapy(CRRT) time, and changes in vasoactive-inotropic score(VIS). To comprehensively evaluate the effect of cytokine adsorption on perioperative outcomes, we will also determine whether there are differences in the length of intensive care unit (ICU) stay, total hospitalization costs, and all-cause mortality.

show abstract

“…It has the potential to reduce the occurrence of AKI and decrease the need for renal replacement therapy. Further research is needed to validate these findings and assess long-term outcomes [15]. In summary, several studies have reported positive outcomes with CytoSorb in emergency cardiac surgery, including shorter operative times, lower blood transfusions, and shorter intensive care unit stays.…”

Section: A Pilot Study By M Diab Et Al Called Remove-pilot Compared C...mentioning

confidence: 95%

An In-Depth Analysis of the Multi-Faceted Benefits of Cytosorb Filter Utilization during Cardiopulmonary Bypass

Butt,

Aziz,

Phillips

2023

J Critical Care & Emerg Med

View full text Add to dashboard Cite

Introduction: Cardiopulmonary bypass (CPB) is a vital component of many cardiac surgeries, but it can trigger systemic inflammatory responses, leading to post-operative complications. The CytoSorb filter, a cytokine adsorber, has emerged as a potential adjunctive therapy in CPB to mitigate inflammation. Method: A literature review was conducted to assess the impact of CytoSorb on inflammation and clinical outcomes during cardiac surgery with CPB. Various databases were searched including PubMed, MEDLINE, and Google Scholar using relevant keywords. Results: Studies have shown mixed results regarding CytoSorb’s efficacy in reducing pro-inflammatory cytokines and improving clinical outcomes. Some studies reported reduced cytokine levels, improved hemodynamics, and decreased need for vasopressors. However, others found no significant cytokine reduction or clinical improvement. CytoSorb was generally well-tolerated with no device-related serious adverse events reported. Additionally, CytoSorb demonstrated potential benefits in reducing bleeding complications when used in patients taking antiplatelet or anticoagulant medications during cardiac surgery. Discussion: The use of CytoSorb in cardiac surgery with CPB holds promise but requires further research. Future directions include evaluating long-term benefits and safety, refining patient selection criteria, conducting comparative studies, standardizing guidelines for CytoSorb integration, and exploring its utility in other cardiac surgery scenarios. Conclusion: CytoSorb offers potential benefits in attenuating systemic inflammation during cardiac surgery with CPB. While evidence suggests positive outcomes in specific contexts, more research is needed to establish its regular use and optimize patient care. Collaborative decision-making and individualized patient management are essential when considering CytoSorb therapy. Continued investigation will provide valuable insights into its precise role in managing inflammation during CPB, enhancing patient outcomes, and refining clinical protocols.

show abstract

Hemadsorption in patients requiring V‐A ECMO support: Comparison of Cytosorb versus Jafron HA330

Cited by 6 publications

References 32 publications

Hemoadsorption in Heart Failure Requiring Mechanical Circulatory Support—A Systematic Review and Meta-Analysis

Hemoadsorption in Heart Failure Requiring Mechanical Circulatory Support—A Systematic Review and Meta-Analysis

Cytokine adsorption in patients with cardiac arrest receiving extracorporeal cardiopulmonary resuscitation (CAECR): a randomized controlled clinical trial protocol

An In-Depth Analysis of the Multi-Faceted Benefits of Cytosorb Filter Utilization during Cardiopulmonary Bypass

Contact Info

Product

Resources

About