Table 1 Evidence overview – infective endocarditis associated valve surgery
From: The role of hemoadsorption in cardiac surgery – a systematic review
No | Study | Study design | Device | Interventions | Controls | Results of the intervention |
|---|---|---|---|---|---|---|
1 | 2017 Träger, K., et al. [5] | Retrospective Case-controla | CytoSorb® (intra-op on CPB) | 39 | 28 | Notably: - shorter ICU length of stay Pre- vs post-treatment: - reduction in vasopressor demand - reduction of cytokine IL-6 & IL-8 levels Rapid normalization of: - lactate levels and base excess - MAP |
2 | 2019 Kühne, L. U., et al. [6] | Retrospective Case-controla | CytoSorb® (intra-op on CPB + post-op on CRRT) | 10 | 10 | Despite a more pronounced disease severity in patients who received the therapy both intra- and postoperatively, compared to those with only intra-op hemoadsorption, equal post-op: - vasopressors - CRP - lactate - ventilator time |
3 | 2020 Haidari, Z., et al. [7] | Retrospective Case–control | CytoSorb® (intra-op on CPB) | 30 | 28 | Significantly: - lower incidence of sepsis (primary outcome) - lower sepsis-related mortality (primary outcome) - reduced vasopressor requirements - higher SVR Notably lower overall 30-day mortality |
4 | 2021 Asch, S., et al. [8] | Prospective RCT | CytoSorb® (intra-op on CPB + post-op on CRRT) | 10 | 10 | Significantly: - higher vasopressor need - higher volume of fluids - longer ICU length of stay No significant difference in cytokine levels – primary outcome (IL-6, TNF-α) CRP and PCT baseline levels were significantly higher in the intervention group, equalizing after surgery |
5 | 2021 Santer, D., et al. [9] | Retrospective Case–control (IPTW) | CytoSorb® (intra-op on CPB) | 41 | 200 | Significantly: - higher norepinephrine and milrinone demand - more RBC and PLT transfusions - higher incidence of reoperations for bleeding - prolonged hospitalization No significant difference in in-hospital mortality – primary outcome |
6 | 2022 Diab, M., et al. [10] | Prospective RCT | CytoSorb® (intra-op on CPB) | 138 | 144 | Significantly: - lower levels of cytokines IL-1β, IL-18 (in the first 25 vs 25 patients) No significant difference in SOFA score change (primary outcome), as well as in clinical outcomes |
7 | 2022 Haidari, Z., et al. [11] | Retrospective Case–control (PSM) | CytoSorb® (intra-op on CPB) | 35 | 35 | Significantly: - lower sepsis-related mortality (primary outcome) - reduced vasopressor demand - higher SVRI - faster SOFA score normalization - lower respiratory failure rate No significant difference in the postoperative sepsis incidence and in-hospital mortality – primary outcomes |
8 | 2022 Holmen, A., et al. [12] | Prospective RCT | CytoSorb® (intra-op on CPB) | 10 | 9 | Significantly: - fewer transfusions (RBC, PLT, FFP) Notably: - lower and shorter norepinephrine demand (primary outcome) - lower creatinine levels - lower chest-tube drainage volume - shorter ventilator time |
9 | 2022 Kalisnik, J. M., et al. [13] | Retrospective Case–control (PSM) | CytoSorb® (intra-op on CPB) | 99 | 99 | Significantly: - lower incidence of sepsis (primary outcome) - lower sepsis-related mortality (primary outcome) - lower CRP levels - fewer transfusions (RBC & FFP) - lower WBC counts - higher hemoglobin level Notably lower in-hospital mortality |
10 | 2023 Haidari, Z., et al. [14] | Retrospective Case–control | CytoSorb® (intra-op on CPB) | 75 | 55 | Significantly: - decreased VIS (primary outcome) - lower incidence of sepsis-related mortality - lower 30-day & 90-day mortality - lower incidence of renal failure requiring hemodialysis Notably: - lower incidence of revisions for bleeding |