Coronary Artery Disease Clinical Trial
Official title:
Reduction of Inflammation Reaction to Extracorporeal Circulation in Cardiac Surgery by Interleukin Dialysis
The aim of this study is to prove that using a CytoSorb(TM) filter in the cardiopulmonary circuit attenuates the inflammatory response to extracorporeal circulation in patients undergoing cardiac surgery. The hypothesis is that removing cytokines from patients' blood by the CytoSorb device significantly improves circulation and outcome in patients undergoing on-pump cardiac surgery.
Cardiac surgery with cardiopulmonary bypass (CPB) induces an inflammatory response due to
contact of patients' blood with foreign surfaces like tubes or the oxygenator,
ischemic-reperfusion injury and surgical trauma. Inflammation is modulated by cytokines,
especially, interleukins. The extent of cytokine release is further related to the duration
of bypass and the amount of operating field suction. This results in a systemic inflammatory
response syndrome (SIRS) with the risk of multiple organ dysfunction (MOD). Also in patients
treated with extracorporeal membrane oxygenation (ECMO) an activation of the inflammation
system is seen and accompanied with an increase of cytokine levels. The cytokine
concentration correlates with the severity of the immune reaction and can be a predictor of
the outcome of the patient. As severe SIRS and MOD significantly increase mortality, the
attenuation of the inflammatory response is supposed to reduce morbidity and mortality after
cardiac surgery.
For adult cardiac surgery and patients who are treated with an extracorporal assist device, a
tool for cytokine elimination and attenuation of the inflammatory response seems to be
beneficial.
In our study we are going to investigate if the use of the CytoSorb device can improve the
outcome of patients undergoing elective coronar artery bypass and heart valve surgery.
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