Modulating the Inflammatory Response With Hemadsorption (CytoSorb) in Patients Undergoing Major Aortic Surgery

Mehta, Yatin; Singh, Ajmer; Singh, Anita; Gupta, Aditi; Bhan, Anil

doi:10.1053/j.jvca.2020.06.028

Cited by 20 publications

(24 citation statements)

References 5 publications

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“…HA significantly reduced the need for vasopressors, blood transfusion, and improved acid-base balance. Another small retrospective pilot study [ 87 ] included 16 patients undergoing elective aortic surgery with moderate hypothermic CPB obtained similar results. In addition, this study was the first to observe the effect of HA on improving PF (PaO 2 /FiO 2 ) ratio and shortening mechanical ventilation duration.…”

Section: Evidence For the Application Of Cytosorb During Cpb Surgerymentioning

confidence: 69%

Application of Adsorptive Blood Purification Techniques during Cardiopulmonary Bypass in Cardiac Surgery

Liu

Zhou

2022

Oxidative Medicine and Cellular Longevity

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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.

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Section: Evidence For the Application Of Cytosorb During Cpb Surgerymentioning

confidence: 69%

Application of Adsorptive Blood Purification Techniques during Cardiopulmonary Bypass in Cardiac Surgery

Liu

Zhou

2022

Oxidative Medicine and Cellular Longevity

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“…Table A1 in Appendix A depicts details from articles included in our review [13,. From these papers, four were selected for a pooled comparative analysis due to their inclusion of both Cytosorb and a control cohort [64,75,77,79].…”

Section: Resultsmentioning

confidence: 99%

“…Mehta et al [77] compared outcomes between patients undergoing aortic surgery with Cytosorb installed in the cardiopulmonary bypass circuit with patients undergoing conventional surgery without Cytosorb adsorber. At baseline, after the induction of anesthesia, there was no difference in the median dosage of norepinephrine in the Cytosorb or control groups, and vasopressor requirements remained similar at 2 h after discontinuation of CPB (Figure 3a).…”

Section: Analysis Of Studies With Control Cohortsmentioning

confidence: 99%

The Potential Role of Extracorporeal Cytokine Removal in Hemodynamic Stabilization in Hyperinflammatory Shock

et al. 2021

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Hemodynamic instability due to dysregulated host response is a life-threatening condition requiring vasopressors and vital organ support. Hemoadsorption with Cytosorb has proven to be effective in reducing cytokines and possibly in attenuating the devastating effects of the cytokine storm originating from the immune over-response to the initial insult. We reviewed the PubMed database to assess evidence of the impact of Cytosorb on norepinephrine needs in the critically ill. We further analyzed those studies including data on control cohorts in a comparative pooled analysis, defining a treatment effect as the standardized mean differences in relative reductions in vasopressor dosage at 24 h. The literature search returned 33 eligible studies. We found evidence of a significant reduction in norepinephrine requirement after treatment: median before, 0.55 (IQR: 0.39–0.90); after, 0.09 (0.00–0.25) μg/kg/min, p <0.001. The pooled effect size at 24 h was large, though characterized by high heterogeneity. In light of the importance of a quick resolution of hemodynamic instability in the critically ill, further research is encouraged to enrich knowledge on the potentials of the therapy.

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“…Song et al reported the high survival rates of critically-ill COVID-19 patients on extracorporeal membrane oxygenation by using CytoSorb ® therapy in the retrospective multi-centric study [121]. Table 2 summarizes the peer-reviewed articles examining the benefits of CytoSorb ® treatment [115,116,120,[122][123][124][125][126][127][128][129][130][131][132][133][134][135][136][137]. Most of the evidence regarding the effectiveness of CytoSorb ® is based on case series, case studies and retrospective reports.…”

Section: Innovative Therapeutic Alternativesmentioning

confidence: 99%

Sepsis Management in Southeast Asia: A Review and Clinical Experience

Mehta

Paul

Rabbani

et al. 2022

JCM

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Sepsis is a life-threatening condition that causes a global health burden associated with high mortality and morbidity. Often life-threatening, sepsis can be caused by bacteria, viruses, parasites or fungi. Sepsis management primarily focuses on source control and early broad-spectrum antibiotics, plus organ function support. Comprehensive changes in the way we manage sepsis patients include early identification, infective focus identification and immediate treatment with antimicrobial therapy, appropriate supportive care and hemodynamic optimization. Despite all efforts of clinical and experimental research over thirty years, the capacity to positively influence the outcome of the disease remains limited. This can be due to limited studies available on sepsis in developing countries, especially in Southeast Asia. This review summarizes the progress made in the diagnosis and time associated with sepsis, colistin resistance and chloramphenicol boon, antibiotic abuse, resource constraints and association of sepsis with COVID-19 in Southeast Asia. A personalized approach and innovative therapeutic alternatives such as CytoSorb® are highlighted as potential options for the treatment of patients with sepsis in Southeast Asia.

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Modulating the Inflammatory Response With Hemadsorption (CytoSorb) in Patients Undergoing Major Aortic Surgery

Cited by 20 publications

References 5 publications

Application of Adsorptive Blood Purification Techniques during Cardiopulmonary Bypass in Cardiac Surgery

Application of Adsorptive Blood Purification Techniques during Cardiopulmonary Bypass in Cardiac Surgery

The Potential Role of Extracorporeal Cytokine Removal in Hemodynamic Stabilization in Hyperinflammatory Shock

Sepsis Management in Southeast Asia: A Review and Clinical Experience

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