Deppe, A. -C., Weber, C., Choi, Y. -H. and Wahlers, T. (2016). Use of cytokine filters in cardiopulmonary bypass machines. Modification of postoperative inflammatory responses. Z. Herz Thorax Gefasschir., 30 (4). S. 254 - 260. CHAM: SPRINGER INTERNATIONAL PUBLISHING AG. ISSN 1435-1277
Full text not available from this repository.Abstract
Background. Cardiac surgical interventions using a cardiopulmonary bypass (CPB) machine induce a systemic inflammatory reaction due to activation of multiple inflammatory cascades. In the postoperative phase this can result in systemic inflammatory response syndrome (SIRS). The activation of various mediators of inflammation, such as interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) can lead to postoperative complications, organ dysfunction, morbidity andmortality. Aim. The effect of adsorption of cytokines using CytoSorb (R) with a CPB machine during cardiac surgery is evaluated. Material and methods. This study is being conducted as a prospective, observational pilot study to determine the clinical impact of the use of an adsorption filter (CytoSorb (R)) on the serum levels of IL-6, IL-8 and TNF-alpha using a CPB machine. This pilot study includes 300 patients planned for elective surgical myocardial revascularization, partitioned into 3 groups each with 100 patients with on-pump myocardial revascularization with CytoSorb (R), on-pump myocardial revascularization without CytoSorb (R) and off-pump myocardial revascularization. Primary outcome measures are the inflammatory response serum parameters IL-6, IL-8, TNFalpha, complement C3/C4, leucocyte counts and C-reactive protein. Secondary outcome measures are length of intensive care unit (ICU) and total hospital stay, duration of ventilation, duration of catecholamine therapy, kidney injury as well as major adverse cardiac and cerebrovascular events (MACCE, mortality, myocardial infarction and cerebrovascular events). Results. An interimanalysis after concluding 60% of the planned patients revealed a well-balanced group allocation of patients. In the group with CytoSorb (R) the IL-6 values are decreased, whereas TNF-alpha values are comparable between the three groups. There seems to be a tendency for less infections in this group. Conclusion. The use of the CytoSorb (R) filter during CPB is safe compared with the standard procedure and applicable without technical difficulties. CytoSorb (R) reduces the cytokine load and seems to attenuate the inflammatory response. Initial positive tendencies in improved clinical endpoints need to subsequently be confirmed in continuing studies.
| Item Type: | Journal Article | ||||||||||||||||||||
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| URN: | urn:nbn:de:hbz:38-269251 | ||||||||||||||||||||
| DOI: | 10.1007/s00398-016-0075-4 | ||||||||||||||||||||
| Journal or Publication Title: | Z. Herz Thorax Gefasschir. | ||||||||||||||||||||
| Volume: | 30 | ||||||||||||||||||||
| Number: | 4 | ||||||||||||||||||||
| Page Range: | S. 254 - 260 | ||||||||||||||||||||
| Date: | 2016 | ||||||||||||||||||||
| Publisher: | SPRINGER INTERNATIONAL PUBLISHING AG | ||||||||||||||||||||
| Place of Publication: | CHAM | ||||||||||||||||||||
| ISSN: | 1435-1277 | ||||||||||||||||||||
| Language: | German | ||||||||||||||||||||
| Faculty: | Unspecified | ||||||||||||||||||||
| Divisions: | Unspecified | ||||||||||||||||||||
| Subjects: | no entry | ||||||||||||||||||||
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| Refereed: | Yes | ||||||||||||||||||||
| URI: | http://kups.ub.uni-koeln.de/id/eprint/26925 |
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