#3285 EXTRACORPOREAL BLOOD PURIFICATION DURING OPEN HEART SURGERY WITH PROLONGED CPB: CYTOSORB 300 VS JAFRON HA330

Abstract

Abstract Background and Aims Cardiac surgery is maintained by various complications. Major contribution associated with cardiopulmonary bypass (CBP). Cardiac surgery with CPB provokes activation of the cascade mechanism of inflammation with releasing of cytokines and a systemic inflammatory response syndrome (SIRS). Activation of the contact system due to exposure of artificial surface of the bypass circuit to blood cells, endotoxemia, ischemia and reperfusion injury and surgical trauma are all potential triggers of inflammation following CPB. This inflammatory reaction may leads to the development of postoperative complications, including vasoplegia, cytokine storm, myocardial dysfunction, respiratory failure, acute kidney injury, coagulopathy bleeding, and multiple organ dysfunction syndrome (MODS). A number of different strategies, including new pharmacologic agents, CPB circuits and components, and surgical techniques, have been employed during the last few years in attempts to minimize the impact of SIRS on the outcome of cardiac surgical patients. However, the complex pathophysiology of this problem has not allowed, until now, the use of a single strategy. The aim of our study is assessment of early application of extracorporeal cytokine adsorbers to the inflammation system during open-heart surgery with prolonged cardiopulmonary bypass. Method This prospective randomized single-center controlled trial observed patients, who were assigned a planned open cardiac surgery with a duration of cardiopulmonary bypass (CPB) more than 120 minutes between January 2021 to January 2023. Patients were randomized into three groups: CytoSorb -300 group, HA 330 group and the control group. A simple 1:1:1 randomization method was applied. Cytokine hemadsorption was conducted intraoperatively. Two types of cytokine cartridges were applied CytoSorb 300 (Cytosorbents Europe GmbH). НА330 (Jafron Biomedical Co., Ltd. China). The inclusion criteria: age ≥18 years, informed consent to participate in the study, CPB more than 120 min. The exclusion criteria: Age less than 18 years; refusal to participate in the study. Results The data of the HA 330 (n = 22) and CytoSorb300 (n = 22) groups were compared with the data of the control group (n = 22). The primary results and details of the work are given in Tables 1-3. Conclusion Intraoperative hemadsorption may be beneficial for patients who underwent open-heart surgery with prolonged CPB. The early hemadsorption has positive impact to postoperative period after cardiac surgery and may reduce requirement of renal replacement therapy.