Efficacy of hemadsorption combining with cardiopulmonary bypass used in patients with acute type A aortic dissection.

BACKGROUND

It is hypothesized that combining HA380 with cardiopulmonary bypass (CPB) in acute type A aortic dissection (ATAAD) surgery could reduce the inflammatory response induced by CPB and subsequently improve prognosis.? Therefore, we aimed to assess the short-term effectiveness of combining HA380 with CPB in treating ATAAD.

METHODS

This study exclusively included individuals diagnosed with ATAAD at our institution from January 2021 to April 2023. After propensity score matching (PSM), patients were allocated into two groups: the hemadsorption (HA) group (n = 45) and the control group (n = 45). The outcome measures included commonly used clinical inflammatory markers, coagulation function, liver and kidney function, ventilator time, and time of ICU stay duration.

RESULTS

Patients in the HA group exhibited elevated postoperative levels of procalcitonin and systemic coagulation-inflammation index (SCI), along with lower white blood cell counts and blood urea nitrogen levels compared to the control group. The HA group had a significantly higher 60-day postoperative survival rate compared to the control group. While the HA group experienced reduced in-hospital mortality and stroke incidence, only the reduction in stroke incidence showed a significant association with the intervention after adjusting for confounders.

CONCLUSION

The application of HA380 does not significantly reduce all postoperative inflammatory indicators in ATAAD surgery. The reduction in inflammatory response was also not obvious. However, it was associated with a significantly lower stroke incidence and improved 60-day survival, suggesting potential clinical benefits in specific outcomes. The specific mechanisms underlying the lower rates of stroke and mortality require further investigation.