Blood washing in endocarditis surgery brings no advantage

Inflammation of the heart valves is a life-threatening disease. If such endocarditis is treated surgically, a type of blood wash is often used to reduce the inflammatory markers in the blood. Researchers at the Jena University Hospital have now been able to show that this procedure does not improve the success of the treatment.

Endocarditis can develop when bacteria, for example from an inflamed tooth or an infected vein access, enter the heart with the blood and cause inflammation there. In more than half of the cases, the only option is surgical removal of the areas of inflammation and reconstruction or replacement of the infected heart valves. Due to the high release of inflammatory messengers, the infection affects the entire body, so that this heart operation is associated with a particularly high risk. Therefore, a so-called haemoadsorption is often used during the operation, in which the inflammatory markers are removed from the blood by a filter process outside the body. “However, the clinical benefit of this plausible-sounding approach has only been insufficiently tested by studies,” says intensive care physician Prof. Dr. Michael Bauer from the Jena University Hospital.

The research team around Dr. In a controlled, multi-centre study, Bauer has now investigated whether the reduction of these inflammatory markers in the blood during surgery is advantageous. This is apparently not the case, as the scientists report in the journal Circulation: Hemoadsorption brought no advantage in terms of the severity of organ failure, mortality or the necessary support procedures. About a fifth of the study patients in both groups died within a month. Common complications such as shock or acute renal failure occurred to the same extent in both groups.

For the study, 282 patients at 14 heart surgery centers in Germany who had to be operated on for endocarditis were examined. They were randomly divided into two groups – one had the adsorption filter used during the procedure, while the control group did not.

Which: DOI 10.1161/CIRCULATIONAHA.121.056940