N . Jabayeva et al .: J Extra Corpor Technol 2024 , 56 , 45 – 54 51 Figure 2 . Continued .
cardiopulmonary bypass in these patients . Duration of CPB was found to be an independent predictor of acute renal failure [ 24 ]. However , in the present study , there was no statistically significant difference in the rate of postoperative renal failure in patients when blood purification was used . This might be due to the sample size and heterogenicity of patients .
The difference in NT-proBNP and TNF-a in the three groups can not be predicted . This effect should be studied as a cartridge saturation in the next studies .
Series HA cartridges are extensively used in China , and only some cases of fever and transient thrombocytopenia have been demonstrated [ 18 , 20 ]. In our study , just one case of thrombocytopenia was detected in the Jafron HA group . Such results indicate that the sorbents are biocompatible and safe for haemosorption during CPB in cardiac surgery . Based on our data , the use of the HA procedure is possible and safe with both CytoSorb 300 and HA 330 adsorbents . The application of both adsorbers does not present any technical difficulties .
In summary , our results show that HA reduced intraoperative levels of inflammatory mediators , but had no effect on CSA-AKI in patients after long-term CPB . The heterogeneous nosological characteristics of patients and their small quantitative component , on the one hand , can serve as such an explanation . On the other hand , the standardized characteristics of the perfusion period may need to be personalized for the patient / nosology or reevaluated in terms of pumps used – roller or centrifugal .
For many years , the hemofiltration technique used during CPB did not demonstrate significant benefits in reducing inflammatory mediators . Currently used sorbents have a different mechanism of action , saturating the cartridge with inflammatory molecules ( reducing their concentration in the bloodstream ). So , the resulting blood load with inflammatory mediators at the intra- and early postperfusion period may facilitate early restoration of kidney function and less need for RRT .
Study limitations
Our study has several limitations that need to be addressed . This is a single-center experience of the use of adsorbers during cardiac surgery with prolonged cardiopulmonary bypass . In addition , the number of patients included in the study limited the strength and generalization of the results .
Conclusion
We found no significant difference in the incidence of CSA-AKI in the early postoperative period after long-term CPB using CytoSorb-300 and HA-330 . HA therapy leads to