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Peer-reviewedCC BYIntensive care medicine experimental

The impact of intraoperative hemoadsorption during cardiac surgery for infective endocarditis.

  • Amin Serradj1,2
  • Gabriel Saiydoun3
  • Costin Radu3
  • Eric Bergoend3
  • Antonio Fiore3
  • Raphaelle Huguet4
  • Pascal Lim4
  • Cyrus Moini5
  • Thierry Folliguet3
5 affiliations
  1. 1Chirurgie Cardiaque et Transplantation, Assistance-Publique Hôpital Henri Mondor, Université Paris 12 UPEC, Paris, France. [email protected].
  2. 2Department of Thoracic and Cardiovascular Surgery, Henri Mondor University Hospital APHP, 1 rue Gustave Eiffel, Créteil, 94000, Paris, France. [email protected].
  3. 3Chirurgie Cardiaque et Transplantation, Assistance-Publique Hôpital Henri Mondor, Université Paris 12 UPEC, Paris, France.
  4. 4Service de Cardiologie, Assistance Publique Hôpital Henri Mondor, Université Paris 12 UPEC, Paris, France.
  5. 5Service de Cardiologie, Hôpital de Melun, Melun, France.
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Abstract

Background

Postoperative sepsis and/or systemic inflammatory response syndrome caused by infective endocarditis (IE) can lead to significant postoperative mortality. Intraoperative hemoadsorption therapy has shown promising results in the treatment of sepsis and dysregulated inflammatory response during cardiac surgery. The aim of this study was to evaluate the effects of intraoperative hemoadsorption in high-risk patients with IE undergoing cardiac surgery.Methods

A total of 176 high-risk patients with IE were enrolled from 10/2020 to 10/2024. Patients with intraoperative hemoadsorption (HA group, n = 93) were compared to patients without hemoadsorption (control, n = 83). The primary endpoint was a composite of 30-day mortality, incidence of vasoplegic syndrome within the first 24 h and 7 days postoperatively, and intensive care (ICU) stay, analyzed using an unmatched hierarchical win-ratio method.Results

There were no differences in baseline characteristics between the groups. The mean hemoadsorption time was 106 ± 61 min in the HA group. Vasoplegic syndrome was more frequent in the control group (49.4% vs. 24.7%, p < 0.001). Importantly, 30-day mortality was also significantly lower with intraoperative hemoadsorption (7.5% vs. 20.5%, p = 0.003). The mean ICU stay was shorter in the HA group (7.8 ± 4.6 vs. 11.5 ± 4.2 days, p < 0.001). The analysis met the primary endpoint in favor of patients receiving intraoperative hemoadsorption (win ratio 3.83; 95% CI 2.55, 5.74; p < 0.001).Conclusions

In high-risk cardiac surgery patients with IE, the intraoperative use of hemoadsorption was associated with a significantly lower incidence of postoperative vasoplegic syndrome and lower overall 30-day mortality. These findings should be interpreted in the context of the study's methodological limitations and confirmed in future randomized controlled trials.Trial registration

This study was approved by the Institutional Review Board (IRB00012919) of the French Society of Thoracic and Cardiovascular Surgery (CERCSFCTCV20251021).

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Cite

BibTeXRIS
BibTeX
@article{serradj2026impact,
  title = {{The impact of intraoperative hemoadsorption during cardiac surgery for infective endocarditis.}},
  author = {Amin Serradj and Gabriel Saiydoun and Costin Radu and Eric Bergoend and Antonio Fiore and Raphaelle Huguet and Pascal Lim and Cyrus Moini and Thierry Folliguet},
  journal = {Intensive care medicine experimental},
  year = {2026},
  month = oct,
  doi = {10.1186/s40635-026-00988-0},
  url = {https://europepmc.org/article/MED/42873407},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - The impact of intraoperative hemoadsorption during cardiac surgery for infective endocarditis.
AU  - Amin Serradj
AU  - Gabriel Saiydoun
AU  - Costin Radu
AU  - Eric Bergoend
AU  - Antonio Fiore
AU  - Raphaelle Huguet
AU  - Pascal Lim
AU  - Cyrus Moini
AU  - Thierry Folliguet
PY  - 2026
DA  - 2026/10/14
JO  - Intensive care medicine experimental
DO  - 10.1186/s40635-026-00988-0
UR  - https://europepmc.org/article/MED/42873407
AB  - Background  Postoperative sepsis and/or systemic inflammatory response syndrome caused by infective endocarditis (IE) can lead to significant postoperative mortality. Intraoperative hemoadsorption therapy has shown promising results in the treatment of sepsis and dysregulated inflammatory response during cardiac surgery. The aim of this study was to evaluate the effects of intraoperative hemoadsorption in high-risk patients with IE undergoing cardiac surgery.Methods  A total of 176 high-risk patients with IE were enrolled from 10/2020 to 10/2024. Patients with intraoperative hemoadsorption (HA group, n = 93) were compared to patients without hemoadsorption (control, n = 83). The primary endpoint was a composite of 30-day mortality, incidence of vasoplegic syndrome within the first 24 h and 7 days postoperatively, and intensive care (ICU) stay, analyzed using an unmatched hierarchical win-ratio method.Results  There were no differences in baseline characteristics between the groups. The mean hemoadsorption time was 106 ± 61 min in the HA group. Vasoplegic syndrome was more frequent in the control group (49.4% vs. 24.7%, p < 0.001). Importantly, 30-day mortality was also significantly lower with intraoperative hemoadsorption (7.5% vs. 20.5%, p = 0.003). The mean ICU stay was shorter in the HA group (7.8 ± 4.6 vs. 11.5 ± 4.2 days, p < 0.001). The analysis met the primary endpoint in favor of patients receiving intraoperative hemoadsorption (win ratio 3.83; 95% CI 2.55, 5.74; p < 0.001).Conclusions  In high-risk cardiac surgery patients with IE, the intraoperative use of hemoadsorption was associated with a significantly lower incidence of postoperative vasoplegic syndrome and lower overall 30-day mortality. These findings should be interpreted in the context of the study's methodological limitations and confirmed in future randomized controlled trials.Trial registration  This study was approved by the Institutional Review Board (IRB00012919) of the French Society of Thoracic and Cardiovascular Surgery (CERCSFCTCV20251021).
SN  - 2197-425X
ER  -