Effect of extracorporeal membrane oxygenation combined with hemoperfusion on inflammatory factors in patients with cardiogenic shock

doi:10.4330/wjc.v17.i8.109903

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Aug 26, 2025 (publication date) through Aug 21, 2025

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World Journal of Cardiology

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1949-8462

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Cardiol. Aug 26, 2025; 17(8): 109903
Published online Aug 26, 2025. doi: 10.4330/wjc.v17.i8.109903

Table 1 Baseline characteristics, n (%)

	ECMO (n = 42)	ECMO+HP (n = 39)	P value
Age, year	56.6 ± 14.3	59.2 ± 12.0	0.231
Male	34 (81.0)	24 (61.5)	0.091
Body mass index, kg/m²	25.7 ± 3.3	24.8 ± 2.6	0.102
Etiology of cardiogenic shock
Acute myocardial infarction	30 (71.4)	27 (69.2)	0.807
Myocarditis	2 (4.8)	1 (2.6)
Postcardiac surgery	10 (23.8)	11 (28.2)
Hypertension	24 (57.1)	21 (53.8)	0.765
Diabetes	14 (33.3)	10 (25.6)	0.449
White blood cell, 10⁹/L	10.0 (8.3, 15.0)	9.7 (6.8, 14.4)	0.33
Blood platelet, /L	186.0 (145.0, 249.0)	151.0 (83.0, 209.0)	0.126
APTT, seconds	38.7 (28.6, 54.4)	37.5 (27.4, 52.1)	0.606
Procalcitonin, ng/mL	2.3 (0.6, 11.2)	2.2 (0.3, 15.7)	0.712
Alanine aminotransferase, U/L	62.5 (25.5, 127.0)	63.0 (29.0, 313.0)	0.292
Total bilirubin, μmol/L	14.7 (9.1, 29.7)	14.1 (8.8, 26.7)	0.484
Serum creatinine, μmol/L	94.0 (71.5, 123.5)	95.0 (72.0, 163.0)	0.577
Left ventricular ejection fractions	31.5 (19.5, 39.0)	36.0 (29.0, 41.0)	0.097
SOFA score	10.0 (8.0, 12.0)	10.0 (9.0, 12.0)	0.181
APACHEII score	14 (12, 17)	17 (14, 19)	0.073
Vasoactive-inotropic score	19.3 ± 1.9	19.1 ± 2.0	0.782
SIRS	11 (26.2)	13 (33.3)	0.482

ECMO: Extracorporeal membrane oxygenation; HP: Hemoperfusion; APTT: Activated partial thromboplastin time; SOFA: Sequential organ failure assessment; APACHE II: Acute Physiology and Chronic Health Evaluation II; SIRS: Systemic inflammatory response syndrome.

Table 2 Inflammatory factors and clinical indicator in two groups

	T0	T6	T12	D1	D2	D3	P value
C-reactive protein, mg/L
ECMO	36.0 (10.4, 107.7)	62.7 (37.4, 124.9)	74.5 (48.7, 123.1)	98.5 (59.0, 152.6)	132.8 (75.2, 181.4)	130.8 (84.9, 193.3)	< 0.001
ECMO+HP	34.6 (22.4, 113.3)	128.3 (63.6, 178.3)^a	65.3 (37.3, 91.0)^a	43.2 (25.9, 64.6)^a	31.5 (21.2, 53.9)^a	18.3 (9.7, 25.6)^a	< 0.001
Interleukin-6, pg/mL
ECMO	203.5 (118.7, 420.0)	310.6 (221.0, 462.9)	341.0 (133.9, 549.5)	247.3 (175.2, 460.6)	391.9 (234.8, 494.2)	339.9 (202.0, 485.4)	0.109
ECMO+HP	214.1 (160.9, 388.0)	146.3 (108.9, 225.4)^a	101.0 (69.2, 123.4)^a	57.0 (45.4, 78.5)^a	32.7 (24.3, 47.5)^a	11.9 (9.3, 15.6)^a	< 0.001
Lactic acid, mmol/L
ECMO	14.6 (11.0, 17.4)	17.9 (14.0, 20.7)	17.4 (14.2, 21.0)	17.9 (13.2, 20.4)	18.0 (14.4, 20.6)	16.2 (12.7, 20.7)	0.115
ECMO+HP	16.1 (12.7, 18.4)	5.5 (2.7, 11.4)^a^,^b	2.9 (1.9, 4.5)^a^,^b	1.8 (1.5, 2.4)^a^,^b	1.4 (1.2, 2.0)^a^,^b	1.3 (0.9, 2.5)^a^,^b	< 0.001
Tumor necrosis factor-α, pg/mL
ECMO	416.6 ± 81.8	423.0 ± 68.4	420.6 ± 75.4	414.1 ± 70.0	435.5 ± 70.0	420.1 ± 69.4	0.834
ECMO+HP	412.0 ± 90.7	307.1 ± 95.1^a	249.6 ± 84.1^a^,^b	216.0 ± 79.0^a^,^b	178.2 ± 66.4^a^,^b	123.3 ± 58.5^a^,^b	< 0.001
Mean arterial pressure, mmHg
ECMO	60.2 ± 9.4	61.3 ± 7.5	61.5 ± 6.3	63.2 ± 6.6	64.8 ± 8.0	62.4 ± 6.8	0.312
ECMO+HP	58.9 ± 8.5	59.5 ± 7.4	60.0 ± 5.4	61.3 ± 6.9	62.0 ± 6.0	60.8 ± 6.4	0.187

^aP < 0.05 vs ECMO group (two-way analysis of variance with Fisher’s least significant difference post hoc).

^bP < 0.05 vs T0 within group (Wilcoxon signed-rank test).

ECMO: Extracorporeal membrane oxygenation; HP: Hemoperfusion.

Table 3 Complications and prognosis in two groups, n (%)

	ECMO (n = 42)	ECMO+HP (n = 39)	P value
Hemorrhage	13 (31.0)	12 (30.8)	0.986
Infection	22 (56.4)	17 (43.6)	0.429
Central nervous system dysfunction	5 (11.9)	4 (10.3)	0.723
Use of intra-aortic balloon pumping	34 (81.0)	31 (79.5)	0.774
Use of continuous renal replacement therapy	17 (40.5)	21 (53.8)	0.228
ECMO operation time, hour	135.0 (73.0, 199.3)	114.0 (75.0, 139.0)	0.046
Successful weaning of ECMO	18 (42.9)	26 (66.7)	0.013
SOFA after weaning	9 (8, 10)	7 (6, 8)	< 0.001
SIRS after weaning	11 (26.2)	4 (10.3)	0.077
Vasoactive-inotropic score	9.8 1.6	8.4 1.3	< 0.001
Duration of hospitalization, d	23 (13, 45.3)	22 (10, 41)	0.762
In-hospital survival	22 (52.4)	25 (64.1)	0.285
30-day survival	15 (38.5)	18 (46.2)	0.492
90-day survival	13 (33.3)	16 (41.0)	0.482

ECMO: Extracorporeal membrane oxygenation; HP: Hemoperfusion; SOFA: Sequential Organ Failure Assessment score; SIRS: Systemic inflammatory response syndrome.

Citation: Hao JY, Wang SF, Yang Q, Wang W, Zhao ZX, Guo S, Zhou Y, Dong F, Lin WH. Effect of extracorporeal membrane oxygenation combined with hemoperfusion on inflammatory factors in patients with cardiogenic shock. World J Cardiol 2025; 17(8): 109903
URL: https://www.wjgnet.com/1949-8462/full/v17/i8/109903.htm
DOI: https://dx.doi.org/10.4330/wjc.v17.i8.109903