{"title":"Hemoadsorption use in adult cardiac surgery for infective endocarditis: A comprehensive meta-analysis.","authors":"Palak Dutta, Rohit Ganduboina, Cankutay Muderrisoglu, Adithya C Reddy Obulareddy, Keerthi Palagati, Vivekananda Reddy Areddy, Gaddam Ashwith Reddy, Sandeep Sainathan","doi":"10.1177/02184923251328119","DOIUrl":null,"url":null,"abstract":"<p><p>IntroductionInfective endocarditis (IE) is a severe infection of the endocardium, primarily affecting the heart valves, exhibiting high morbidity and mortality rates. Cardiac surgery for IE with cardiopulmonary bypass (CPB) can further exacerbate the inflammatory response and cytokine production from IE. The current meta-analysis evaluates the use of CytoSorb<sup>®</sup> hemoadsorption in IE patients undergoing cardiac surgery to determine its efficacy in reducing inflammatory mediators and improving clinical outcomes.MethodsPubMed, Cochrane, Google Scholar, Clinical Trials, and Google Scholar were searched for articles until July 2024. After performing a risk of bias and quality assessment, data on operative times, mortality, and morbidity were extracted for meta-analysis. Statistical Software R (version 4.4.0) was used to calculate odds ratio (OR) and standardized mean differences using a random-effect model with a 95% confidence interval (CI) and <i>p</i>-value less than 0.05.ResultsEight studies, encompassing 1076 patients, were included in the analysis. These comprised three randomized controlled trials and five nonrandomized studies. The majority of these studies exhibited some concerns regarding bias. Hemoadsorption group showed lower discharge mortality (OR: 0.58, 95% CI: 0.33-1.00, <i>p</i> = 0.05) compared to controls, but no significant disparity is observed in other outcomes. In-hospital outcomes also showed higher heterogeneity, with an <i>I</i>² value greater than 50%.ConclusionCytoSorb use in patients undergoing cardiac surgery with CPB used for IE has no impact on operative mortality and morbidity but has a beneficial effect on discharge mortality.</p>","PeriodicalId":35950,"journal":{"name":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","volume":" ","pages":"2184923251328119"},"PeriodicalIF":0.7000,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"ASIAN CARDIOVASCULAR & THORACIC ANNALS","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/02184923251328119","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
IntroductionInfective endocarditis (IE) is a severe infection of the endocardium, primarily affecting the heart valves, exhibiting high morbidity and mortality rates. Cardiac surgery for IE with cardiopulmonary bypass (CPB) can further exacerbate the inflammatory response and cytokine production from IE. The current meta-analysis evaluates the use of CytoSorb® hemoadsorption in IE patients undergoing cardiac surgery to determine its efficacy in reducing inflammatory mediators and improving clinical outcomes.MethodsPubMed, Cochrane, Google Scholar, Clinical Trials, and Google Scholar were searched for articles until July 2024. After performing a risk of bias and quality assessment, data on operative times, mortality, and morbidity were extracted for meta-analysis. Statistical Software R (version 4.4.0) was used to calculate odds ratio (OR) and standardized mean differences using a random-effect model with a 95% confidence interval (CI) and p-value less than 0.05.ResultsEight studies, encompassing 1076 patients, were included in the analysis. These comprised three randomized controlled trials and five nonrandomized studies. The majority of these studies exhibited some concerns regarding bias. Hemoadsorption group showed lower discharge mortality (OR: 0.58, 95% CI: 0.33-1.00, p = 0.05) compared to controls, but no significant disparity is observed in other outcomes. In-hospital outcomes also showed higher heterogeneity, with an I² value greater than 50%.ConclusionCytoSorb use in patients undergoing cardiac surgery with CPB used for IE has no impact on operative mortality and morbidity but has a beneficial effect on discharge mortality.
期刊介绍:
The Asian Cardiovascular and Thoracic Annals is an international peer-reviewed journal pertaining to cardiovascular and thoracic medicine. Besides original clinical manuscripts, we welcome research reports, product reviews, reports of new techniques, and findings of special significance to Asia and the Pacific Rim. Case studies that have significant novel original observations, are instructive, include adequate methodological details and provide conclusions. Workshop proceedings, meetings and book reviews, letters to the editor, and meeting announcements are encouraged along with relevant articles from authors.