Table 2 Evidence overview – elective complex cardiac surgery (various procedures with prolonged CPB)
From: The role of hemoadsorption in cardiac surgery – a systematic review
No | Study | Study design | Device | Interventions | Controls | Results of the intervention |
|---|---|---|---|---|---|---|
1 | 2016 Bernardi, M. H., et al. [15] | Prospective RCT | CytoSorb® (intra-op on CPB) | 19 | 18 | No significant difference in primary outcome—cytokine levels (IL-1ß, IL-6, IL-18, TNF-⍺), except for IL-10 |
2 | 2019 Bernardi, M. H., et al. [18] | Prospective RCT (post hoc subgroup analysis of No. 1) | CytoSorb® (intra-op on CPB) | 17 | 18 | Significantly: - higher haptoglobin (primary outcome) - lower LDH No significant difference between the groups in levels of plasma-free hemoglobin (primary outcome) and total bilirubin |
3 | 2019 Garau, I., et al. [19] | Prospective RCT | CytoSorb® (intra-op on CPB) | 20 | 20 | Significantly: - lower cytokine levels (IL-8, TNF-⍺)—primary outcome - higher CI No significant difference in levels of IL-6 (primary outcome) |
4 | 2019 Gleason, T. G., et al. [20] | Prospective RCT | 2 CytoSorb® (intra-op on CPB) | 23 | 23 | Significant reduction in: - plasma-free hemoglobin (primary outcome) - activated complement C3a & C5a |
5 | 2019 Poli, E. C., et al. [21] | Prospective RCT | CytoSorb® (intra-op on CPB) | 15 | 15 | No significant difference in primary outcome—cytokine levels (IL-1a, IL-1b, IL-2, IL-4, IL-5, IL-6, IL-10, TNF-α, IFN-γ, MCP-1), as well as in clinical outcomes Significantly lower activity of coagulation factors II and XII |
6 | 2019 Wagner, R., et al. [22] | Prospective RCT | CytoSorb® (intra-op on CPB) | 15 | 13 | Significantly higher level of miRNA-133 – primary outcome No significant differences in levels of miRNA-1, miRNA-126, and miRNA-223 (primary outcomes), as well as in clinical outcomes |
7 | 2019 Taleska-Stupica, G., et al. [23] | Prospective RCT | CytoSorb® (intra-op on CPB) | 20 | 20 & 20a | Significantly: - higher CD64 and CD163 antigen expression on immune cells - increased activated complement C5a (primary outcomes) No significant difference in primary outcome—cytokine levels (TNF-α, IL-1β, IL-6, IL-8, and IL-10) |
8 | 2020 Wisgrill, L., et al. [24] | Prospective RCT (post hoc subgroup analysis of No. 1) | CytoSorb® (intra-op on CPB) | 9 | 9 | No significant differences in circulating microvesicles, apoptotic body counts and kinetics |
9 | 2021 Hohn, A., et al. [16] | Prospective Case series (part of the ongoing RECCASb study) | CytoSorb® (intra-op on CPB) | 15 | / | Significant, pre- vs post-adsorber: - reduction of heparan sulphate - increase of hyaluronan |
10 | 2022 Manohar, M., et al. [17] | Retrospective Case–control | CytoSorb® (intra-op on CPB) | 23 | 29 | Significantly lower: - increase of VIS from pre- to postoperative value (primary outcome) Notably lower: - in-hospital mortality |