Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu 610041, China.
Oxid Med Cell Longev. 2022 May 25;2022:6584631. doi: 10.1155/2022/6584631. eCollection 2022.
By reason of surgical demand, the majority of cardiovascular procedures still depend on the use of cardiopulmonary bypass (CPB). Due to the nonphysiological state of CPB, it can cause complex and unpredictable inflammatory response, which may lead to significant morbidity and mortality. Unfortunately, the pharmacological and mechanical strategies that currently exist do not offer significant advantages in controlling inflammatory response and improving patient outcomes. The best strategy to reduce inflammation in CPB is still uncertain. In recent years, adsorptive blood purification techniques (BPTs) have emerged, among which CytoSorb is the latest representative device. Currently, the primary application area of adsorptive BPTs is in the control and treatment of systemic hyperinflammatory states, such as refractory septic shock patients. However, the evidences on efficacy and safety of adsorptive BPTs application during CPB surgery are still inconclusive, so we summarize the relevant evidences here and suggest future potential research areas.
由于手术需求,大多数心血管手术仍然依赖体外循环(CPB)。由于 CPB 的非生理状态,它会引起复杂且不可预测的炎症反应,这可能导致显著的发病率和死亡率。不幸的是,目前存在的药理学和机械策略在控制炎症反应和改善患者预后方面并没有提供显著优势。减轻 CPB 中炎症的最佳策略仍然不确定。近年来,出现了吸附性血液净化技术(BPTs),其中 CytoSorb 是最新的代表性设备。目前,吸附性 BPTs 的主要应用领域是控制和治疗全身性炎症反应状态,如难治性感染性休克患者。然而,CPB 手术中应用吸附性 BPTs 的疗效和安全性证据仍不明确,因此我们在这里总结了相关证据,并提出了未来潜在的研究领域。