In view of their potential applications in sandwich structures, there has been increasing interest in honeycomb networks. Several different types of honeycomb systems have been proposed each exhibiting different mechanical properties. Here we propose a new hexagonal honeycomb structure composed of two different geometrical features: a re‐entrant feature which is known to generate auxetic behavior, and a non re‐entrant feature found in regular hexagonal honeycombs which leads to conventional behavior. This results in a “semi re‐entrant honeycomb” built of alternate conventional and auxetic layers. Finite element analysis and analytical modeling of these honeycombs show that they exhibit a zero Poisson ratio in one direction and a higher than normal Young's modulus in the orthogonal direction. We also show that by virtue of its zero Poisson's ratio, this honeycomb has a natural tendency to form cylindrical shaped curvatures, something which is very difficult to achieve with conventional or auxetic honeycombs.

The CytoSorb adsorber, a blood purification therapy, is able to remove molecules in the 5-60 kDa range which comprises the majority of inflammatory mediators and some endogenous molecules. We aimed to evaluate CytoSorb therapy on clinical outcomes in critically ill patients. A retrospective case series study, from February 2016 to May 2017, was performed in 40 patients with multiple organ failure who received CytoSorb treatment. There were 28 patients with cardiogenic shock, 2 with septic shock, 9 with acute respiratory distress syndrome, and 1 with liver failure. Nineteen patients (47%) underwent extracorporeal membrane oxygenation, 11 (27%) had an intra-aortic balloon pump, 9 (22%) were implanted with Impella, 6 (15%) had a ventricular assist device, and 18 (45%) were treated with continuous veno-venous hemofiltration. After CytoSorb treatment, total bilirubin decreased from 11.6 ± 9.2 to 6.8 ± 5.1 mg/dL (P = 0.005), lactate from 12.1 ± 8.7 to 2.9 ± 2.5 mmol/L (P < 0.001), CPK from 2416 (670-8615) to 281 (44-2769) U/L (P <0.001) and LDH from 1230 (860-3157) to 787 (536-1148) U/L (P <0.001). The vasoactive-inotropic score after 48 h of treatment was reduced to 10 points, P = 0.009. Thirty-day mortality was 55% and ICU mortality was 52.5% at expected ICU mortality of 80%. Our study shows that CytoSorb treatment is effective in reducing bilirubin, lactate, CPK and LDH, in critically ill patients mainly due to cardiogenic shock. There is a need for randomized controlled trials to conclude on the potential benefits blood purification with CytoSorb in critically ill patients.

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