Hemoadsorption use in adult cardiac surgery for infective endocarditis: A comprehensive meta-analysis.

IF 0.7 Q3 Medicine
Palak Dutta, Rohit Ganduboina, Cankutay Muderrisoglu, Adithya C Reddy Obulareddy, Keerthi Palagati, Vivekananda Reddy Areddy, Gaddam Ashwith Reddy, Sandeep Sainathan
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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.

血液吸附在成人心脏手术治疗感染性心内膜炎中的应用:一项综合荟萃分析。
感染性心内膜炎(IE)是一种严重的心内膜感染,主要影响心脏瓣膜,具有很高的发病率和死亡率。体外循环(CPB)的IE心脏手术可进一步加剧IE的炎症反应和细胞因子的产生。目前的荟萃分析评估了在接受心脏手术的IE患者中使用CytoSorb®血液吸附剂,以确定其在减少炎症介质和改善临床结果方面的疗效。方法检索spubmed、Cochrane、谷歌Scholar、临床试验和谷歌Scholar,检索截止到2024年7月的文章。在进行偏倚风险和质量评估后,提取手术时间、死亡率和发病率的数据进行meta分析。采用统计学软件R (version 4.4.0)计算优势比(OR)和标准化平均差异,采用随机效应模型,95%置信区间(CI), p值小于0.05。结果8项研究,共1076例患者被纳入分析。其中包括三个随机对照试验和五个非随机研究。这些研究中的大多数都表现出对偏见的担忧。血液吸附组出院死亡率低于对照组(OR: 0.58, 95% CI: 0.33 ~ 1.00, p = 0.05),其他指标差异无统计学意义。住院结果也显示出较高的异质性,I²值大于50%。结论cysorb在心脏手术CPB行IE患者中的应用对手术死亡率和发病率无影响,但对出院死亡率有有利影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.30
自引率
0.00%
发文量
78
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.
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