Cardiac surgery leeds to a systematic inflammatory response induced by the surgical trauma and the use of the cardiopulmonary bypass (CPB). Activation of inflammatory cascades can cause a systemic inflammatory response syndrome (SIRS) which is associated with increased morbidity and mortality. Therefore, strategies to reduce the inflammatory response have a potential benefit for cardiac surgery patients. The clinical benefit of reducing proinflammatory cytokines such as IL-6, Il-8 and TNF-a with the use of a cytokine adsorbing circuit (Cytosorb) during CBP remains unclear. Therefore, the investigators conduct this prospective, observational pilot study to determine the clinical impact of the use of a cytokine adsorbing circuit during CBP.
Patients, who have an elective myocardial revascularization and give there written consent will be enrolled to the study. Demographic, intraoperative, and postoperative data will be collected prospectively. Furthermore, blood samples (1. before induction of anaesthesia 2. at the end of CPB 3. 6 hours after surgery 4. 24 hours after surgery 5. 3-5 days after surgery) will be analyzed.
Study Type
OBSERVATIONAL
Enrollment
300
University Hospital of Cologne; Department of Cardiothoracic Surgery
Cologne, Germany
RECRUITINGEvolution of the inflammatory response
Il-6; Il-8; TNF-a; C3/C4-complement Leucocytes CRP
Time frame: Change from Baseline in cytokine level direct after surgery, 6 and 24 hours after surgery; 5. postoperative day
Length of ICU and hospital stay
Length of ICU and hospital stay
Time frame: participants will be followed for the duration of hospital stay, an expected average of 10 days
Length of ventilation
Length of ventilation (hours)
Time frame: participants will be followed for the duration of hospital stay, an expected average of 10 days
Length of catecholamine therapy
Length of catecholamine therapy
Time frame: participants will be followed for the duration of hospital stay, an expected average of 10 days
kidney injury
kidney injury defined as an increase in SCr by ≥1.0 mg/dl (≥26.5 μmol/l) after surgery ; or Increase in SCr to ≥1.5 times baseline, or Urine volume \< 0.5 ml/kg/h for 6 hours.
Time frame: participants will be followed for the duration of hospital stay, an expected average of 10 days
MACCE (mortality; myocardial infarction; cerebrovascular accident)
Mortality measured as any kind of death and myocardial death Myocardial Infarction measured with ECG; CK-MB, cTnT Cerebrovascular accident verified with abnormal cerebral CT scan
Time frame: participants will be followed for the duration of hospital stay, an expected average of 10 days
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