Department of Cardiovascular Surgery, General Hospital of Western Theater Command, Chengdu, China.
College of Medicine, Southwest Jiaotong University, Chengdu, China.
Heart Surg Forum. 2023 Jan 11;26(1):E020-E026. doi: 10.1532/hsf.5213.
Cardiopulmonary bypass (CPB) induces inflammatory homeostasis dysregulation, closely related to many postoperative adverse effects. Minimizing the systemic inflammatory response to CPB is imperative to improving cardiac surgery safety. This study aimed to retrospectively evaluate the efficacy of the hemoperfusion cartridge, a device recently designed for extracorporeal blood purification to remove cytokines from the blood for patients undergoing cardiac valve replacement surgery using CPB.
The hemoperfusion (HP) group consisted of 138 patients, who underwent a hemoperfusion cartridge procedure during CPB. The control group included 149 patients, who received standard CPB management. The evaluated indices included inflammatory cytokines, blood biochemical indices, and postoperative outcome indices.
Patients in the HP group had relatively lower interleukin (IL)-6 levels (days one and two post-CPB) and IL-8 (day one post-CPB) compared with the control group. Some relatively decreased biochemical blood indices also were observed in the HP group, including a significantly lower lactic acid level (days one, two, and three post-CPB), platelet counts (days one, two, and three post-CPB), and aspartate aminotransferase (days one and three post-CPB). Regarding the postoperative outcomes, no severe complications occurred in the patients; however, the HP group required less ventilation time than the control group.
The hemoperfusion cartridge seems promising in limiting the inflammatory reactions during CPB, with noteworthy potential for application in cardiac surgery.
体外循环(CPB)会引起炎症平衡失调,这与许多术后不良影响密切相关。最大限度地减少 CPB 引起的全身炎症反应对于提高心脏手术安全性至关重要。本研究旨在回顾性评估血液灌流盒的疗效,该装置是最近设计用于体外血液净化的,用于从接受 CPB 的心脏瓣膜置换术患者的血液中去除细胞因子。
血液灌流(HP)组包括 138 例患者,这些患者在 CPB 期间进行了血液灌流盒处理。对照组包括 149 例患者,这些患者接受了标准 CPB 管理。评估的指标包括炎症细胞因子、血液生化指标和术后结局指标。
与对照组相比,HP 组患者的白细胞介素(IL)-6 水平(CPB 后第 1 天和第 2 天)和 IL-8(CPB 后第 1 天)相对较低。HP 组还观察到一些相对较低的生化血液指标,包括乳酸水平(CPB 后第 1、2 和 3 天)、血小板计数(CPB 后第 1、2 和 3 天)和天冬氨酸转氨酶(CPB 后第 1 天和第 3 天)显著降低。就术后结局而言,患者未发生严重并发症;然而,HP 组需要的通气时间比对照组少。
血液灌流盒似乎在限制 CPB 期间的炎症反应方面具有前景,在心脏手术中具有潜在的应用价值。