ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Pediatric Cardiology
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1615697
Hemoadsorption contribution in neonatal cardiac surgery
Provisionally accepted
Isabella Molinari1*
Enrico Aidala1Maria Teresa Cascarano1Maria Stella Di Carlo1Cristina Rivoldini1Enrico Bonaveglio2
Carlo Pace Napoleone1- 1Pediatric and Congenital Cardiac Surgery and Cardiology, Ospedale Pediatrico Regina Margherita, Torino, Piedmont, Italy
- 2Pediatric Cardiac Anesthesiology and Intensive Care Unit, Ospedale Pediatrico Regina Margherita, Torino, Piedmont, Italy
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Background: Cardiopulmonary bypass (CPB) in paediatric open-heart surgery is challenging, especially in neonates and aortic arch surgery. It induces a systemic inflammatory response that can lead to significant postoperative complications, including multiorgan dysfunction, prolonged mechanical ventilation, and intensive care unit (ICU) stay. Blood purification with hemoadsorbers integrated into CPB has been proposed as a strategy to reduce these side effects. These devices adsorb cytokines from the bloodstream, trying to modulate their negative systemic effect. Methods: This retrospective study evaluates 33 neonates who underwent complex cardiac surgeries between January 2022 and January 2025 at Regina Margherita Children's Hospital. 17 of them had been treated with Jafron HA60 hemoadsorber during CPB. Biomarkers of organ damage (creatinine, lipase, aspartate transaminase, and alanine transaminase), C-reactive protein, lactates, inotropic drugs doses and a wide range of pro-and anti-inflammatory cytokines were analysed during surgery and in the intensive care unit. Results: The results showed a decrease in biomarkers of organ damage and inflammation, accompanied by a tendency toward reduction in the required dose of inotropes, ICU stays, days of mechanical ventilation, and duration of required open chest time in the treated group. A similar downward pattern was observed in cytokine levels. Conclusions: Hemoadsorption may be associated with improved clinical parameters in neonates undergoing high-risk cardiac surgery. Further large-scale studies are needed to explore these observations.
Keywords: pediatric cardiac surgery, neonatal cardiac surgery, Hemoadsorption, cytokine, Inflammatory Response, Cardiopulmonary Bypass
Received: 08 May 2025; Accepted: 01 Sep 2025.
Copyright: © 2025 Molinari, Aidala, Cascarano, Di Carlo, Rivoldini, Bonaveglio and Pace Napoleone. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Isabella Molinari, Pediatric and Congenital Cardiac Surgery and Cardiology, Ospedale Pediatrico Regina Margherita, Torino, Piedmont, Italy
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