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Effect of haemoadsorption during cardiac surgery for Staphylococcus aureus endocarditis: a REMOVE trial post hoc analysis

2024; Oxford University Press; Volume: 65; Issue: 3 Linguagem: Inglês

10.1093/ejcts/ezae093

1873-734X

Túlio Caldonazo, Jef Van den Eynde, Torsten Doenst, Hristo Kirov, Marcus Franz, Stefan Hagel, Thomas Lehmann, Mahmoud Diab, Mahmoud Diab, Thomas Lehmann, Wolfgang Bothe, Payam Akhyari, Stephanie Platzer, Daniel Wendt, Antje‐Christin Deppe, Justus Strauch, Stefan Hagel, Albrecht Günther, Gloria Faerber, Christoph Sponholz, Marcus Franz, André Scherag, Ilia Velichkov, Miriam Silaschi, Jens Faßl, Britt Hofmann, Sven Lehmann, René Schramm, Georg Fritz, Gábor Szabó, Thorsten Wahlers, Klaus Matschke, Artur Lichtenberg, Mathias W. Pletz, Jan Gummert, Christian Hagl, Michael A. Borger, Michael Bauer, Frank M. Brunkhorst, Torsten Doenst, Isabella Schiller, Marcus Winter, Cornelia Eichhorn, Aicko Helbig, Florian Rißner, Kubanychbek Abdyvasiev, Alexandros Moschovas, S. Freiburger, Rauf Safarov, Steffen Bargenda, Hristo Kirov, Markus Richter, T. Sandhaus, Natig Zeynalov, Mirko Kaluza, Denis Bösemann, Swen Boog, Romanus Ostermann, P. Christian Schulze, Ali Hamadanchi, Rita Musleh, Otto W. Witte, Petra Bloos, Katrin Schwope, Steffi Kolanos, Karina Knuhr-Kohlberg, Anja Haucke, Katja Lehmann, Carolyn Weber, Amila Cizmic, C Grathwohl, Dirk Sindhu, Markus Schaschek, Axel Baier, Sébastien Schaub, Uwe Großkurth, Eranya Sone Herré, A. V. Vlasov, Dimitry Podanev, Tobias Plettenberg, Thomas Mühlbauer, Irawati Tunggal, Madlen Eichler, Jasmina Cosic, Vera C. Wolf, Petra Krause, Stephanie Krischer, Matthias Thielmann, Ingo Wiese, Tobias Hillmer, Jörg von Manstein, Markus Deus, Dusko Ljesic, Daniel Roloff, Tim Alabowicz Wolfgang Ristau, Gina Spangel, Johannes Kroll, Fatos Ballazhi, Stoyan Kondov, Matthias Siepe, Bartosz Rylski, Johannes Scheumann, Matthias D′ Inka, Matthias Eschenhagen, Yasir Al-Hamami, Nils Bauer, Martin Thoma, Albena Rambach, Christian Ziemann, Gustavo Fernandez Baca Garcia, Julia Morlock, Christoph Benk, Alina Klink, Christoph Maltes, Gabriele Lechner, Veronika Blümel, Ulrike Heizmann, Priscilla Kotzjan, Peter Haldenwang, Mahmoud Elghannam, Dritan Useini, Dirk Buchwald, Bärbel Buchwald, Thomas Schröter, Christian Binner, Philipp Hartung, David Holzhey, Martín Misfeld, Christian D. Etz, Piroze Davierwala, Sergey Leontyev, Bettina Pfannmüller, Jens Garbade, Konstantin von Aspern, Diyar Saeed, Muhammed Ali Aydın, Jonathan Herzfeld, Stefan Feder, Philipp Kiefer, Anna L. Meyer, Joerg Seeburger, Philipp C. Münch, Jörg Prehl, René Ginther, Josephine Koch, Salome Hecht, H. Winkler, Berit Fritzsche, Johann Winata, Julia Schmidt, Jakob Labus, Isabell Frei, Volker H. Schmidt, Katrin Plötze, Susanne Schal, Moritz Benjamin Immohr, Yukiharu Sugimura, Anne Gietmann, Andreas Simm, Florian Höpfner, Markus Stiller, Kathrin Ludwig, Sven Helms, J. Sunavsky, Julia Götte, Markus Rudloff, Andrea Schönbrodt, Swetlana Fink, Ina‐Maria Albrecht, Alice Huguette Minko Nnanga, Carola Schneider, Heike Schilling, Tanja Maier, Ralf‐Uwe Kühnel, Stelios Ioannou, Anna-Maria Necaev, Torsten Müller, Ralph Bienek, Hendrik Treede, Zaki Kohistani, Touraj Ahmadpour, Sonja Friese, Andreas Oberbach, Maximilian Luehr, Dominik Jóskowiak, J Buch,

Central Venous Catheters and Hemodialysis

Abstract OBJECTIVES Multi-organ failure is one of the leading causes of mortality after cardiac surgery for infective endocarditis (IE). Although the randomized evidence does not support the use of haemoadsorption during cardiac surgery for IE, observational studies suggest a beneficial effect in selected patient groups. Staphylococcus aureus is the most common pathogen, and its presence is an independent mortality predictor. We aimed to analyse the effect of haemoadsorption in patients with IE caused by S. aureus. METHODS This is a post hoc analysis of the REMOVE trial that randomized 288 patients with IE who underwent cardiac surgery with haemoadsorption using CytoSorb® or control. The primary outcome was ΔSequential Organ Failure Assessment (SOFA), defined as the difference between the mean total postoperative and baseline SOFA score within 24 h of surgery. RESULTS Among the total of 282 patients included in the modified intention-to-treat analysis of the REMOVE trial, 73 (25.9%) had S. aureus IE (38 patients in the haemoadsorption group and 35 patients in the control group). The overall ΔSOFA did not differ between the intervention groups in patients with S. aureus IE (mead difference = −0.4, 95% confidence interval −2.3 to 1.4, P = 0.66) and neither did 30-day mortality (hazard ratios = 1.32, 95% confidence interval 0.53–3.28, P = 0.55). No differences were observed with regard to any of the other secondary outcomes. CONCLUSIONS Based on a post hoc analysis from REMOVE trial, the intraoperative use of haemoadsorption in patients with S. aureus IE was not associated with reduction of postoperative organ dysfunction, 30-day mortality or other major clinical end points.