Effect Of Hemoadsorption On Organ Function In Patients With Type A Aortic Dissection

Objective: To explore the effect of intraoperative combined hemoadsorption therapy on postoperative organ function and postoperative complications in Standford A aortic dissection patients requiring cryogenic circulation-arrest surgery.Methods: A total of 1 21 patients with aortic type A dissection were enrolled in the Cardiac Surgery Department of the First Affiliated Hospital of Anhui Medical University from August 2020 to December 2022.they were randomly divided into experimental group(HA group)and cont rol group(CO group).Inflammatory factors and clinical indicators before,0h and 24 h after CPB were collected from each group,and daily SOFA and average SOFA difference from baseline at 3 days after surgery were calculated.The incidence of postoperative complications and pro gnosis were recordedResults: There was a statistically significant difference in BMI between the HA group and the CO group(P=0.015).Although patients in the HA group were more obese than those in the CO group,the average value of patients in the two groups was close to the high norma l value.There was no significant difference in other preoperative baseline data between the two groups.Compared with CO group,patients in HA group were significantly reduced in the incidence of postop erative AKI and the utilization rate of CRRT(P < 0.05),and there were no significant differences in ΔSOFA,30-day mortality and remaining postoperative complications between the two groups(P>0.05).Within 24 h after surgery,The minimum HCT in HA group was significantly higher than t hat in CO group(P=0.005).In the simple comparison of postoperative Inspection index between the two groups,the level of total Bilirubin on the third postoperative day and interleukin-8 after 0 hours of CPB in the HA group was lower than that in the CO gr oup.After subtracting the preoperative baseline value,compared with CO group,creatinine in HA group was significantly reduced on the second and third day after surgery,glomerular filtration rate in HA group was increased on the second and third day afte r surgery,and total bili rubin level in HA group was lower on the third day after surgery(P < 0.05).After subtracting the preoperative baseline value,the levels of interleukin-6 and interleukin-8 at 0h after CPB in HA group were lower than those in CO group(P < 0.05).Conclusion: In patients with TAAD requiring cryogenic circulatory arrest,intraoperative combined treatment with HA can reduce the incidence of AKI and the use of CRRT,improve postoperative renal function,and may benefit the recovery of postoperative liver funct ion.However,according to ΔSOFA,intraoperative combined HA therapy did not improve overall organ function,and had no significant effect on other organ functions such as respiratory system,nervous system,blood coagulation system,and liver.Intraoperative combined treatment with HA can reduce the early postoperative IL-8 level and slow down the growth trend of IL-6 and IL-8,but has no significant effect on IL-10 and TNF-α.