Effect of hemoperfusion on systemic inflammatory response in patients with V-A extracorporeal membrane oxygenation after off-pump coronary artery bypass grafting
Effect of hemoperfusion on systemic inflammatory response in patients with V-A extracorporeal membrane oxygenation after off-pump coronary artery bypass grafting
Objective:To investigate the changes of inflammatory factors and systemic inflammatory response scores in patients with extracorporeal membrane oxygenation(ECMO)after off-pump coronary artery bypass grafting(OPCABG)and the influence of hemoperfusionn(HP).Methods:The 42 cases of patients who underwent V-A ECMO after OPCABG in the Center for Cardiac Intensive Care,Beijing Anzhen Hospital,from January 2019 to December 2022,were divided into ECMO group(n=24)and ECMO+HP group(n=18).ECMO group was treated by protocol;In the ECMO+HP group,HP time was 18 hours.The observations and HP treatment were started within 24 hours of ECMO catheterization.The general information,levels of inflammatory factors,inflammatory response scores at 0,6,12,18,24,48h,clinical prognostic data were collected.Results:The change rates of CRP,IL-6,IL-8,TNF-α and IL-1β in the ECMO+HP group decreased continuously over time.There were significant differences compared with the ECMO group.LAC,SIRS score and infection rate(5.6％vs.33.3％,P=0.030)was significantly decreased in the ECMO+HP group.The duration time of ECMO was significantly shortened[(132.0±20.1)vs.(155.9±24.2)h,P=0.001],and the rate of weaning off ECMO was significantly increased(83.3％vs.41.7％,P=0.001).Sequential organ failure assessment(SOFA)score[8.0(7.0,9.0)vs.8.0(7.8,9.0),P=0.038]and vasoactive-inotropic score(VIS)[8.0(7.0,9.0)vs.9.0(8.0,10.0),P=0.003]were significantly lower than ECMO group.Conclusions:Hemoperfusion might be associated with the reduction of inflammation and complications in VA-ECMO after OPCABG,but there were no significant differences in length of ICU stay and mortality.
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