This systematic review compared intraoperative hemoadsorption with standard care during cardiac surgery with cardiopulmonary bypass. Six randomized trials included 798 patients. Four trials involving 723 patients reported acute kidney injury within seven postoperative days, without a significant difference between groups (RR 0.93, 95% CI 0.71–1.21). No significant differences were reported in 28-day mortality, SOFA score, or ICU length of stay. Trial sequential analysis reached only 48% of the required information size and crossed neither monitoring nor futility boundaries, leaving uncertainty about benefit.
The available randomized evidence does not demonstrate improved kidney or other clinical outcomes with intraoperative hemoadsorption in elective cardiac surgery. The findings remain inconclusive rather than establishing absence of benefit.
Study limitation: The accrued sample reached only 48% of the required information size, limiting confidence in the negative findings.
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