Clinical experience of using a novel extracorporeal cytokine adsorption column for treatment of septic shock with multiorgan failure

Sathe, Prachee; Sakhavalkar, Prashant; Kumar, S; Choudhary, Sudhanshu

doi:10.1186/cc14210

Cited by 7 publications

(6 citation statements)

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“…In this context, the Cytosorb hemoadsorber has been shown to remove various proinflammatory as well as antiinflammatory cytokines in vitro and in animal models of sepsis (3, 4). Furthermore, recent data derived from case reports hint at clinical improvements in hemodynamics, organ recovery, and suggest that clinical stabilization may occur faster (5–9).…”

Section: Discussionmentioning

confidence: 99%

CytoSorb, a Novel Therapeutic Approach for Patients with Septic Shock: A Case Report

Hinz¹,

Noky²,

Friesecke

et al. 2015

Int J Artif Organs

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The rapid hemodynamic stabilization with reduction of vasopressor needs within hours and reduction of the capillary leakage as well as a quick reduction in infection markers were the main conclusions drawn from the use of CytoSorb in this patient. Additionally, treatment appeared to be safe and was well tolerated. Despite the promising results of CytoSorb application in this patient, further studies are necessary to elucidate to what extent these favorable consequences are attributable to the adsorber itself.

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Section: Discussionmentioning

confidence: 99%

CytoSorb, a Novel Therapeutic Approach for Patients with Septic Shock: A Case Report

Hinz¹,

Noky²,

Friesecke

et al. 2015

Int J Artif Organs

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“…So, altogether, no study using CytoSorb has shown a sustained plasma concentration reduction lasting during the whole treatment. Given the possibility that this technique may hold promise, we reviewed available data with the aim of producing current consensus statements and directing further research [67–69].…”

Section: Rationale For Cytokine Removalmentioning

confidence: 99%

Cytokine removal in human septic shock: Where are we and where are we going?

Honoré

Hoste

Molnár

et al. 2019

Ann. Intensive Care

146

119

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Although improving, the mortality from septic shock still remains high despite increased international awareness. As a consequence, much effort has focused on alternative treatment strategies in an effort to improve outcomes. The application of blood purification therapies to improve immune homeostasis has been suggested as one such method, but these approaches, such as high-volume continuous haemofiltration or cytokine and/or endotoxin removal, have enjoyed little success to date. More recently, the use of sorbent technologies has attracted much attention. These adsorbers are highly effective at removing inflammatory mediators, in particular, cytokines, from the bloodstream. This narrative review is the executive summary of meetings held throughout the 6th International Fluid Academy Days in Antwerp, Belgium (Nov 23–25, 2017), focusing on the current understanding regarding the use of such adsorbers in humans with septic shock. We followed a modified Delphi approach involving a combination of evidence appraisal together with expert opinion in order to achieve recommendations for practice and, importantly, future research.

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“…5 CytoSorb therapy has shown in in vitro and in animal models, that it is able to remove various anti-and proinflammatory cytokines. 6,7 Clinical in septic shock [8][9][10][11][12][13] confirm these results, showing clinical improvements in term of hemodynamic stability and organ healing, whereas in the field of Covid-19 only few experiences have been reported in the literature. [14][15][16] At the time of the treatment of our patient, the synergistic use of CytoSorb and Tocilizumab in Covid-19 and, generally, in the context of cytokine release syndrome, was supported by the experience of Bottari et al 17 However, we did not observe any clinical improvement after the sole Tocilizumab administration, perhaps confirming the following results showed by many clinical trials.…”

Section: Discussionmentioning

confidence: 74%

“…4 CytoSorb therapy (CytoSorbents Corp, New Jersey, USA) is a CE-mark approved sorbent composed of biocompatible porous polymer beads which are able to remove a wide range of substances from whole blood, including the majority of cytokines, inflammatory mediators, endogenous-and some exogenous-molecules through pore capture and surface adsorption. 6 Experimental and clinical studies [6][7][8][9][10][11][12][13] have widely demonstrated CytoSorb's ability to modulate the excessive and uncontrolled immune response, helping to control many of the complications of organ dysfunction in life-threatening illnesses, especially if adopted early within 24 h 12 in patients not responding to the standard therapy. Because of these characteristics, CytoSorb might represent a helpful therapy in septic shock of different etiologies, also in Covid-19 patients, in which only few published experiences are available, [14][15][16] therefore we consider important to report on our own experience.…”

Section: Introductionmentioning

confidence: 99%

Successful use of CytoSorb in a Covid-19 patient with secondary septic shock due to a sacral decubitus infection

et al. 2021

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Septic shock is a clinical condition with high mortality (40%–70%) and morbidity. During septic shock, there is a significant release of cytokines and other inflammatory mediators that can cause damage to different organs, known as a “cytokine storm.” The cytokine storm can cause hypotension, tissue damage, metabolic acidosis, and renal failure. This clinical picture also seems to be confirmed in the context of Covid-19 patients. Hemoadsorption with CytoSorb represents an adjunctive therapy to attenuate the systemic inflammatory process and helps restore a balanced immune response. We present the clinical case of a 75-year-old man, admitted to our hospital with respiratory failure due to Sars-CoV-2 infection and secondary septic shock due to a sacral decubitus. On admission the patient presented with a clinical picture of mixed acidosis with high levels of lactate and inflammatory indexes. Simultaneously along with antibiotic therapy, we started hemoadsorption treatment with CytoSorb in combination with continuous venous-venous hemodiafiltration. At the end of the treatment the patient had recovered his vital functions and the infection was successfully treated. Use of the CytoSorb device in a Covid-19 positive patient was safe and well-tolerated. Early treatment with CytoSorb decreased interleukin 6 plasma levels and inflammatory indexes, resulting in earlier stabilization of homeostasis. This case report suggests that the use of CytoSorb could be a possible adjuvant therapy in patients with septic shock even when affected by Covid-19.

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Clinical experience of using a novel extracorporeal cytokine adsorption column for treatment of septic shock with multiorgan failure

Cited by 7 publications

References 0 publications

CytoSorb, a Novel Therapeutic Approach for Patients with Septic Shock: A Case Report

CytoSorb, a Novel Therapeutic Approach for Patients with Septic Shock: A Case Report

Cytokine removal in human septic shock: Where are we and where are we going?

Successful use of CytoSorb in a Covid-19 patient with secondary septic shock due to a sacral decubitus infection

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