1. Initial experience with CytoSorb therapy in patients receiving left ventricular assist devices
- Author
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Alexander Weymann, Jef Van den Eynde, Bastian Schmack, Markus Kamler, Arian Arjomandi Rad, Arjang Ruhparwar, Lukas Goerdt, Konstantin Zhigalov, Peter Luedike, Alina Zubarevich, Robert Vardanyan, Michel Pompeu Barros de Oliveira Sá, Nikolaus Pizanis, Thomas Chrosch, and Achim Koch
- Subjects
Male ,medicine.medical_specialty ,Respiration, Artificial/statistics & numerical data ,medicine.medical_treatment ,Tracheotomy/statistics & numerical data ,Medizin ,Biomedical Engineering ,Medicine (miscellaneous) ,Bioengineering ,medicine.disease_cause ,Biomaterials ,C-Reactive Protein/analysis ,Leukocyte Count ,Extracorporeal blood purification ,Internal medicine ,medicine ,Overall survival ,Humans ,In patient ,Hospital Mortality ,Artificial/statistics & numerical data ,Adverse effect ,Retrospective Studies ,Heart Failure ,Mechanical ventilation ,Interleukin-6 ,business.industry ,Respiration ,General Medicine ,Middle Aged ,Immune dysregulation ,medicine.disease ,Respiration, Artificial ,Heart-Assist Devices/adverse effects ,Hemofiltration/instrumentation ,C-Reactive Protein ,Treatment Outcome ,Respiratory failure ,Heart failure ,Heart Failure/therapy ,Cardiology ,Female ,Heart-Assist Devices ,Interleukin-6/blood ,Hemofiltration ,Tracheotomy ,Respiratory Insufficiency ,business - Abstract
BACKGROUND: The use of left ventricular assist devices (LVAD) in patients with advance heart failure is still associated with an important risk of immune dysregulation and infections. The aim of this study was to determine whether extracorporeal blood purification using the CytoSorb device benefits patients after LVAD implantation in terms of complications and overall survival.MATERIALS AND METHODS: Between August 2010 and January 2020, 207 consecutive patients underwent LVAD implantation, of whom 72 underwent CytoSorb therapy and 135 did not. Overall survival, major adverse events, and laboratory parameters were compared between 112 propensity score-matched patients (CytoSorb: 72 patients; non-CytoSorb: 40 patients).RESULTS: WBC (p = .033), CRP (p = .001), and IL-6 (p < .001), significantly increased with LVAD implantation, while CytoSorb did not influence this response. In-hospital mortality and overall survival during follow-up were similar with CytoSorb. However, patients treated with CytoSorb were more likely to develop respiratory failure (54.2% vs. 30.0%, p = .024), need mechanical ventilation for longer than 6 days post-implant (50.0% vs. 27.5%, p = .035), and require tracheostomy during hospitalization (31.9% vs. 12.5%, p = .040). No other significant differences were observed with regard to major adverse events during follow-up.CONCLUSIONS: Overall, our results showed that CytoSorb might not convey a significant morbidity or mortality benefit for patients undergoing LVAD implantation.
- Published
- 2021
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