Objective <p>To evaluate the efficacy of the HA380 hemoperfusion device in attenuating systemic inflammatory response during cardiopulmonary bypass (CPB)-assisted cardiac surgery and its influence on perioperative clinical outcomes.</p> Methods <p>This trial enrolled 65 patients who underwent elective cardiac surgery with CPB. Patients were randomly divided into two groups: the experimental group (HP group, <i>n</i> = 34) used the HA380 hemoperfusion device throughout CPB; the control group (<i>n</i> = 31) underwent conventional CPB only. Serum levels of IL-1β, IL-6, IL-8, IL-10, TNF-α, and CRP were measured at: preoperatively (T0), immediately postoperatively (T1), 24&#xa0;h (T2) and 48&#xa0;h (T3) post-surgery. Surgical data, postoperative ICU indicators (duration of intubation, vasoactive-inotropic score [VIS], drainage volume, urine output, ICU stay duration), and first-day postoperative blood routine, liver and kidney function, and coagulation indicators were recorded. Differences between the two groups were compared.</p> Results <p>There were no statistical differences in baseline data between the two groups (<i>P</i> &gt; 0.05). Inflammatory factor analysis showed that serum levels of IL-1β, IL-6, IL-8, and IL-10 in the HP group were significantly lower than the control group (<i>P</i> &lt; 0.05) at T1 and T2. However, no significant differences were observed in TNF-α and CRP levels between the two groups at any time point (<i>P</i> &gt; 0.05). Regarding clinical indicators, the HP group exhibited a lower VIS on postoperative day 1 (<i>P</i> &lt; 0.05); significant reductions in levels of white blood cells, neutrophils, ALT, urea, and creatinine were observed than the control group (<i>P</i> &lt; 0.05). ICU intubation time, drainage volume, and urine output on the first postoperative day, ICU stay duration, hemoglobin, platelet, bilirubin, and other indicators showed no intergroup differences (<i>P</i> &gt; 0.05).</p> Conclusion <p>The combined application of the HA380 blood perfusion device during CPB-assisted cardiac surgery effectively clears medium molecular weight inflammatory mediators (IL-1β, IL-6, IL-8, IL-10), significantly reduces early postoperative systemic inflammatory response, and helps improve early postoperative hemodynamic stability (reducing the need for vasoactive drugs) and short-term liver and kidney function indicators. However, no significant reduction was observed in ICU mechanical ventilation time and ICU stay duration. HA380 demonstrates promise as an adjunct anti-inflammatory therapy, though its long-term benefits and impact on postoperative recovery optimization require further investigation.</p>

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The combined use of HA380 hemoperfusion in cardiopulmonary bypass alleviates postoperative inflammatory response and organ dysfunction following cardiac surgery

  • Longlong Li,
  • Jing Li,
  • Hui Li,
  • Suli Wang,
  • Chunyu Chen,
  • Biao Zhang

摘要

Objective

To evaluate the efficacy of the HA380 hemoperfusion device in attenuating systemic inflammatory response during cardiopulmonary bypass (CPB)-assisted cardiac surgery and its influence on perioperative clinical outcomes.

Methods

This trial enrolled 65 patients who underwent elective cardiac surgery with CPB. Patients were randomly divided into two groups: the experimental group (HP group, n = 34) used the HA380 hemoperfusion device throughout CPB; the control group (n = 31) underwent conventional CPB only. Serum levels of IL-1β, IL-6, IL-8, IL-10, TNF-α, and CRP were measured at: preoperatively (T0), immediately postoperatively (T1), 24 h (T2) and 48 h (T3) post-surgery. Surgical data, postoperative ICU indicators (duration of intubation, vasoactive-inotropic score [VIS], drainage volume, urine output, ICU stay duration), and first-day postoperative blood routine, liver and kidney function, and coagulation indicators were recorded. Differences between the two groups were compared.

Results

There were no statistical differences in baseline data between the two groups (P > 0.05). Inflammatory factor analysis showed that serum levels of IL-1β, IL-6, IL-8, and IL-10 in the HP group were significantly lower than the control group (P < 0.05) at T1 and T2. However, no significant differences were observed in TNF-α and CRP levels between the two groups at any time point (P > 0.05). Regarding clinical indicators, the HP group exhibited a lower VIS on postoperative day 1 (P < 0.05); significant reductions in levels of white blood cells, neutrophils, ALT, urea, and creatinine were observed than the control group (P < 0.05). ICU intubation time, drainage volume, and urine output on the first postoperative day, ICU stay duration, hemoglobin, platelet, bilirubin, and other indicators showed no intergroup differences (P > 0.05).

Conclusion

The combined application of the HA380 blood perfusion device during CPB-assisted cardiac surgery effectively clears medium molecular weight inflammatory mediators (IL-1β, IL-6, IL-8, IL-10), significantly reduces early postoperative systemic inflammatory response, and helps improve early postoperative hemodynamic stability (reducing the need for vasoactive drugs) and short-term liver and kidney function indicators. However, no significant reduction was observed in ICU mechanical ventilation time and ICU stay duration. HA380 demonstrates promise as an adjunct anti-inflammatory therapy, though its long-term benefits and impact on postoperative recovery optimization require further investigation.