Artif Organs. 2022 Nov 17. doi: 10.1111/aor.14457. Online ahead of print.
ABSTRACT
BACKGROUND: ECMO support is associated with the development of a systemic hyper-inflammatory response, which may become quite significant and extreme in some cases. We hypothesise that Cytosorb or Jafron therapy may benefit patients on V-A ECMO in terms of levels of inflammatory markers such as IL-6, complications and overall outcomes.
METHODS: We conducted a retrospective study of prospectively collected data in a single tertiary care center between January 2021 and April 2022. At the time of the analysis of this article, 20 patients on V-A ECMO had cytokine adsorption while on ECMO support: Cytosorb group (n=10), Jafron group (n=10). In 10 ECMO supported patients cytokine adsorption was not used, this group served as a control group, which may be quite significant in some cases. Evaluation of the level of inflammatory markers (IL-1, 6, 8; CRP, Leukocyte, Lactate, PCT, NT-proBNP, TNF-α) were performed.
RESULTS: There were statistically significant longer CPB time, aortic cross clamp time and ICU stay in cytokine adsorption groups than in control group, but there were no differences between subgroups with different types of haemoadsorption used. Moreover, in control group mortality rate was higher than the cytokine adsorption groups (60 % vs 20%, p 0.02). All patients had elevation of inflammatory markers in perioperative and immediate postoperative period. After 72 hours of intensive care, blood inflammation markers had tendency to decline.
CONCLUSION: At the time of writing, hemadsorption in patients requiring V-A ECMO support represents good therapeutic effect. This effect is permanent for the whole period of extracorporeal cytokine hemadsorption application for both CytoSorb and Jafron HA330 devices.
PMID:36398369 | DOI:10.1111/aor.14457
