Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Aug 26, 2025; 17(8): 109903
Published online Aug 26, 2025. doi: 10.4330/wjc.v17.i8.109903
Effect of extracorporeal membrane oxygenation combined with hemoperfusion on inflammatory factors in patients with cardiogenic shock
Jing-Yan Hao, Shi-Fu Wang, Qin Yang, Wei Wang, Zhuo-Xian Zhao, Shan Guo, Ying Zhou, Fei Dong, Wen-Hua Lin
Jing-Yan Hao, Qin Yang, Wen-Hua Lin, Department of Cardiology, TEDA International Cardiovascular Hospital, Tianjin 300457, China
Shi-Fu Wang, Wei Wang, Shan Guo, Intensive Care Unit, TEDA International Cardiovascular Hospital, Tianjin 300450, China
Zhuo-Xian Zhao, Ying Zhou, Fei Dong, Cardiac Care Unit, TEDA International Cardiovascular Hospital, Tianjin 300457, China
Author contributions: Hao JY contributed to study design, data collection, initial manuscript writing; Wang SF and Yang Q contributed to research methodology design, technical support; Wang W and Zhao ZX contributed to data analysis and statistical processing; Guo S and Zhou Y contributed to data validation, figure and table preparation; Dong F contributed to study supervision and project coordination; Lin WH contributed to research guidance, funding acquisition and manuscript review.
Supported by the Priority Project of the Multi-Source Investment Fund Program, China, No. S21DYZD3172; and the Tianjin Key Medical Discipline (Specialty) Construction Project, China, No. TJYXZDXK-020A.
Institutional review board statement: This study was approved by the Ethics Committee of TEDA International Cardiovascular Hospital (Ethics Approval No.: 2022K034). It was conducted in accordance with the principles of the Declaration of Helsinki, and written informed consent was obtained from all patients or their legal guardians.
Informed consent statement: Due to the anonymization of all patient data, no additional consent for publication is required.
Conflict-of-interest statement: All authors declare no financial or non-financial competing interests.
Data sharing statement: The data generated in this study are stored in the TEDA International Cardiovascular Hospital ECMO Registry (Registration No.: 2022-034). Anonymized data may be requested from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen-Hua Lin, PhD, Chief Physician, Department of Cardiology, TEDA International Cardiovascular Hospital, 3rd Street, Tianjin Economic-Technological Development Area, Tianjin 300457, China. linwernhua@sina.com
Received: May 27, 2025
Revised: June 15, 2025
Accepted: July 22, 2025
Published online: August 26, 2025
Processing time: 88 Days and 14.1 Hours
Abstract
BACKGROUND

Data on adsorptive extracorporeal membrane oxygenation (ECMO) (combined with HA380 hemoperfusion column) on the inflammatory factors in patients with cardiogenic shock (CS) remains limited.

AIM

To investigate the effects of adsorptive ECMO on the inflammatory factors in patients with CS.

METHODS

A retrospective analysis was performed on 81 patients with CS caused by acute myocardial infarction, fulminant myocarditis, or cardiac surgery who required venoarterial ECMO support at TEDA International Cardiovascular Hospital from December 2020 to December 2024. Patients were divided into the conventional ECMO group (42 cases) and the adsorptive ECMO group (ECMO combined with hemoperfusion, 39 cases). The adsorptive ECMO group received 2 columns of HA380 initiation on the first day (the first column connected within 2 hours of ECMO and the second after 12 hours of ECMO), followed by 1 column each day, with each column used for 4–6 hours, totaling 24–30 hours of treatment. Baseline data were compared between the two groups: Inflammatory factor levels (at 0, 6, 12, 24, 48, and 72 hours after ECMO or hemoperfusion initiation); ECMO support duration; successful weaning rate; continuous renal replacement therapy (CRRT) utilization; Sequential Organ Failure Assessment (SOFA) score; Vasoactive-Inotropic Score (VIS); systemic inflammatory response syndrome (SIRS) incidence; and in-hospital survival and 30-/90-day survival after discharge.

RESULTS

The adsorptive ECMO group showed significantly lower levels of C-reactive protein, interleukin (IL)-6, tumor necrosis factor (TNF)-α, and lactate from 6 to 72 hours compared with the conventional ECMO group (all P < 0.05), with IL-6 decreasing by 94.4% and tumour necrosis factor alpha by 70.1% from baseline at 72 hours. The adsorptive ECMO group had a significantly shorter ECMO duration [114.0 (75.0–139.0) hours vs 135.0 (73.0–199.3) hours, P = 0.032]; higher successful weaning rate (66.7% vs 42.9%, P = 0.032); a trend toward lower CRRT utilization (54.8% vs 38.5%, P = 0.070); lower post-weaning SOFA score [7 (6–8) vs 9 (8–10), P < 0.001]; significantly reduced VIS (8.4 ± 1.3 vs 9.8 ± 1.6, P < 0.001); and a trend toward lower SIRS incidence (10.3% vs 26.2%, P = 0.065). There were no significant differences in complications, in-hospital survival (64.1% vs 52.4%, P = 0.285); or 30-/90-day survival between the two groups (all P > 0.05).

CONCLUSION

Adsorptive ECMO efficiently clears IL-6 and TNF-α, significantly improving ECMO weaning success rate and hemodynamics. However, it has no significant impact on survival, and its efficacy requires validation through prospective studies.

Keywords: Adsorptive extracorporeal membrane oxygenation; Cardiogenic shock; Inflammatory factors; Hemoperfusion column; Therapeutic outcomes

Core Tip: This study evaluates the efficacy of adsorptive extracorporeal membrane oxygenation (ECMO) (ECMO combined with HA380 hemoperfusion column) in reducing inflammatory burden in cardiogenic shock patients. Our single-center retrospective study (n = 78) demonstrates that adsorptive ECMO efficiently clears pro-inflammatory cytokines (interleukin-6: 94.4% reduction at 72 hours; tumour necrosis factor alpha: 70.1% reduction) and improves hemodynamics, including shorter ECMO duration (114 vs 141 hours, P = 0.046) and higher weaning success rate (66.7% vs 38.5%, P = 0.013).