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Clin Transplant ; 32(4): e13211, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29377282

RESUMO

AIM: The aim of this study was to assess the influence of intraoperative cytokine adsorption on the perioperative vasoplegia, inflammatory response and outcome during orthotopic heart transplantation (OHT). METHODS: Eighty-four OHT patients were separated into the cytokine adsorption (CA)-treated group or controls. Vasopressor demand, inflammatory response described by procalcitonin and C-reactive protein, and postoperative outcome were assessed performing propensity score matching. RESULTS: In the 16 matched pairs, the median noradrenaline requirement was significantly less in the CA-treated patients than in the controls on the first and second postoperative days (0.14 vs 0.3 µg*kg-1 *min-1 , P = .039 and 0.06 vs 0.32 µg*kg-1 *min-1 , P = .047). The inflammatory responses were similar in the two groups. There was a trend toward shorter length of mechanical ventilation and intensive care unit (ICU) stay in the CA-treated group compared to the controls. No difference in adverse events was observed between the two groups. The frequency of renal replacement therapy was less in the CA­treated patients than in the controls. CONCLUSIONS: Intraoperative CA treatment was associated with reduced vasopressor demand with a favorable tendency in length of mechanical ventilation, ICU stay and renal replacement therapy. CA treatment was not linked to higher rates of adverse events.


Assuntos
Citocinas/administração & dosagem , Transplante de Coração/métodos , Inflamação/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Terapia de Substituição Renal/estatística & dados numéricos , Vasoplegia/prevenção & controle , Adulto , Estudos de Casos e Controles , Citocinas/metabolismo , Feminino , Seguimentos , Transplante de Coração/efeitos adversos , Humanos , Inflamação/etiologia , Unidades de Terapia Intensiva , Cuidados Intraoperatórios , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Prognóstico , Pontuação de Propensão , Estudos Prospectivos , Vasoplegia/etiologia
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