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在主动脉瓣置换术体外循环期间使用 Cytosorb ® 成功治疗系统性肥大细胞增多症。

Systemic Mastocytosis Successfully Managed using Cytosorb ® During Cardiopulmonary Bypass for Aortic Valve Replacement.

机构信息

Department of Anaesthesia, ICH, Valais Hospital, Sion, Switzerland.

Department of Cardiac Surgery, ICH, Valais Hospital, Sion, Switzerland.

出版信息

Ann Card Anaesth. 2024 Oct 1;27(4):364-367. doi: 10.4103/aca.aca_16_24. Epub 2024 Aug 28.

DOI:10.4103/aca.aca_16_24
PMID:39206776
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11610785/
Abstract

We describe the case of a 72-year-old male with a history of systemic mastocytosis scheduled for on-pump aortic valve replacement for severe aortic insufficiency. Anesthesia and peri-operative management included avoidance of histamine-releasing drugs, methylprednisolone and clemastin prophylaxis. Furthermore, a CytoSorb ® cartridge has been added to the bypass circuit and hemoadsorption was performed throughout the entire cardiopulmonary bypass (CPB) duration. CytoSorb ® is a hemoadsorption device designed to remove various cytokines and drugs from the blood. The use of CytoSorb ® during CPB in our case was not associated with adverse events, and the patient did not present any allergic or anaphylactic reaction.

摘要

我们描述了一例 72 岁男性患者的病例，该患者患有系统性肥大细胞增多症，拟行体外循环主动脉瓣置换术治疗严重主动脉瓣关闭不全。麻醉和围手术期管理包括避免使用释放组胺的药物、甲基强的松龙和氯马斯汀预防。此外，在体外循环回路中添加了 CytoSorb ® 试剂盒，并在整个体外循环期间进行血液吸附。CytoSorb ® 是一种血液吸附装置，旨在从血液中去除各种细胞因子和药物。在我们的病例中，在体外循环期间使用 CytoSorb ® 与不良事件无关，患者也没有出现任何过敏或过敏反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ae2/11610785/9e379c2cfbc4/ACA-27-364-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ae2/11610785/abd05d59c35d/ACA-27-364-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ae2/11610785/9e379c2cfbc4/ACA-27-364-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ae2/11610785/abd05d59c35d/ACA-27-364-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ae2/11610785/9e379c2cfbc4/ACA-27-364-g002.jpg

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本文引用的文献

1
A Practical Approach to Systemic Mastocytosis Complications in Cardiac Surgery: A Case Report and Systematic Review of the Literature.心脏手术中系统性肥大细胞增多症并发症的实用处理方法：一例病例报告及文献系统综述
J Clin Med. 2023 Feb 1;12(3):1156. doi: 10.3390/jcm12031156.
2
Vasoplegic Syndrome after Cardiopulmonary Bypass in Cardiovascular Surgery: Pathophysiology and Management in Critical Care.心血管手术体外循环后的血管麻痹综合征：重症监护中的病理生理学与管理
J Clin Med. 2022 Oct 29;11(21):6407. doi: 10.3390/jcm11216407.
3
Systemic mastocytosis in adults: 2021 Update on diagnosis, risk stratification and management.
成人系统性肥大细胞增生症：2021 年诊断、风险分层和治疗更新。
Am J Hematol. 2021 Apr 1;96(4):508-525. doi: 10.1002/ajh.26118. Epub 2021 Feb 21.
4
Cytosorb hemoadsorption of apixaban during emergent cardio-pulmonary bypass: a case report.在急诊心肺转流期间阿哌沙班的细胞吸附血液灌流：一例报告。
Perfusion. 2021 Nov;36(8):873-875. doi: 10.1177/0267659120967827. Epub 2020 Oct 26.
5
Cytokine clearance with CytoSorb® during cardiac surgery: a pilot randomized controlled trial.细胞因子清除术联合 CytoSorb® 在心脏手术中的应用：一项前瞻性随机对照试验。
Crit Care. 2019 Apr 3;23(1):108. doi: 10.1186/s13054-019-2399-4.
6
Hemoadsorption with CytoSorb.使用CytoSorb进行血液吸附
Intensive Care Med. 2019 Feb;45(2):236-239. doi: 10.1007/s00134-018-5464-6. Epub 2018 Nov 16.
7
In vitro comparison of the adsorption of inflammatory mediators by blood purification devices.血液净化装置对炎症介质吸附作用的体外比较
Intensive Care Med Exp. 2018 May 4;6(1):12. doi: 10.1186/s40635-018-0177-2.
8
Management around invasive procedures in mastocytosis: An update.肥大细胞增多症侵入性操作的管理：最新进展
Ann Allergy Asthma Immunol. 2017 Oct;119(4):304-309. doi: 10.1016/j.anai.2017.07.022. Epub 2017 Aug 31.
9
Treatment of post-cardiopulmonary bypass SIRS by hemoadsorption: a case series.血液吸附治疗体外循环后全身炎症反应综合征：病例系列
Int J Artif Organs. 2016 May 16;39(3):141-6. doi: 10.5301/ijao.5000492. Epub 2016 Apr 25.
10
Effect of hemoadsorption during cardiopulmonary bypass surgery - a blinded, randomized, controlled pilot study using a novel adsorbent.体外循环手术期间血液吸附的效果——一项使用新型吸附剂的双盲、随机、对照试验性研究
Crit Care. 2016 Apr 9;20:96. doi: 10.1186/s13054-016-1270-0.