The Effect of Intraoperative Hemoadsorption Therapy on Inflammatory Cytokines and Outcomes in Patients With Open Thoracoabdominal Aortic Aneurysm Repair

Background: To evaluate the effect of intraoperative hemoadsorption therapy on inflammatory cytokines and clinical outcomes in patients undergoing open thoracoabdominal aortic aneurysm (TAAA) repair. Methods: A total of 90 patients who underwent TAAA repair at Beijing Anzhen Hospital from May 2018 to December 2024 were enrolled and divided into a hemoadsorption group (HA group, n = 45) and a control group (n = 45). For patients in the HA group, an HA380 hemoadsorption cartridge was integrated in parallel into the cardiopulmonary bypass (CPB) circuit at the start of CPB. Patients in the control group underwent standard surgery without hemoadsorption and were matched to the HA group based on age (±5 years), sex, Crawford types, and comorbidities. We collected data on patient demographics, intraoperative variables (CPB duration, operative time, red blood cell transfusion volume, lactate levels), postoperative variables (duration of mechanical ventilation, intensive care unit [ICU] stay, hospital stay), inflammatory markers (interleukin-6, C-reactive protein, procalcitonin), and postoperative outcomes (mortality and complications). Results: No significant differences were observed between the two groups in CPB time or operative time (p > 0.05). Patients in the HA group had significantly shorter durations of mechanical ventilation, ICU stay, and hospital stay compared to those in the control group (p < 0.05). Intraoperative red blood cell transfusion volume and blood lactate levels were significantly lower in the HA group than those in the control group (p < 0.05). Similarly, serum levels of interleukin-6, C-reactive protein, and procalcitonin were significantly lower in the HA group than those in the control group at 24 and 48 hours (p < 0.05). There were no statistically significant differences in all-cause mortality or overall complication rates between the two groups (p > 0.05). However, the incidence of acute kidney injury (AKI) was significantly lower in the HA group (37.78%) than in the control group (64.44%, p < 0.05), representing a 41.37% relative reduction. Conclusion: In TAAA repair, intraoperative hemoadsorption was associated with a significantly lower incidence of AKI, lower serum levels of interleukin-6, C-reactive protein, and procalcitonin at 24 and 48 hours, and shorter durations of mechanical ventilation, ICU stay, and hospital stay compared with the control group. All-cause mortality and rates of other complications were similar between the two groups.