Modulating the Inflammatory Response With Hemadsorption (CytoSorb) in Patients Undergoing Major Aortic Surgery

This retrospective pilot study was undertaken to evaluate the effect of hemadsorption (HA) with CytoSorb (CytoSorbents Corporation, Monmouth Junction, NJ) on changes in inflammatory markers in patients undergoing aortic surgery. Sixteen consecutive patients were treated either with HA (n = 8) or without it, serving as control patients (n = 8). Treatment with HA resulted in significant reductions in interleukin-6 (IL-6) and procalcitonin levels. It also preserved the mean arterial pressure better, with less norepinephrine requirement, and resulted in a better arterial oxygen partial pressure/fractional inspired oxygen (PaO2/FiO2[PF]) ratio and shorter durations of mechanical ventilation, intensive care unit stay, and hospital stay.

The primary limitations of this study were its retrospective nature and the small number of patients. In addition, we did not evaluate the effect of the HA device on coagulation parameters, postoperative bleeding, or the use of blood/blood products. Nevertheless, currently there are limited data available on aortic surgery and HA therapy, and our data may add important information to those who are planning to design prospective, randomized trials in this patient population.