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

Hinz, Burkhard; Noky, Toralf; Friesecke, Sigrun; Abel, Peter; Kaiser, R

doi:10.5301/ijao.5000429

Cited by 48 publications

(36 citation statements)

References 8 publications

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“…A decrease in bilirubin and IL-6 levels in combination with an improvement in hepatic encephalopathy are the main results to be drawn from this report. This is in line with several case reports [3][4][5] . In conjunction with similar previously published case reports, a controlled study examining the true effects of the device would be desirable.…”

supporting

confidence: 82%

Use of Hemoadsorption in a Case of Severe Hepatic Failure and Hyperbilirubinemia

Faltlhauser¹,

Kullmann²

2017

Blood Purif

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supporting

confidence: 82%

Use of Hemoadsorption in a Case of Severe Hepatic Failure and Hyperbilirubinemia

Faltlhauser¹,

Kullmann²

2017

Blood Purif

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“…nitric oxide production via iNOS) resulting in stabilization of the vascular tone and a reduction in vasoplegia. Moreover, there is evidence, mainly from case reports, that hemoadsorption may have a positive impact on vascular barrier integrity and therefore indirectly on capillary leakage syndrome, which might also be part of the beneficial effects of CytoSorb therapy on hemodynamics [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Application of Hemoadsorption in Neonatal and Pediatric Hyperinflammatory States: A Case Series

Milella¹

2019

AJP

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Objective: Extracorporeal blood purification therapies are increasingly applied in the field of intensive care medicine. Compared to filtration-based methods mainly used for renal replacement therapy, newest adsorptive approaches have shown to specifically target the inflammatory cascade by the effective removal of relevant mediators. In the neonatal and pediatric setting however, the application of these methods brings with it various challenges but also profound technical difficulties. Recently, a promising extracorporeal device for cytokine adsorption (CytoSorb) was introduced. However, data for its application in critically ill pediatric patients remains sparse. Design: Single center retrospective case study; Setting: Tertiary neonatal and pediatric general intensive care unit; Patients: The study comprised 10 critically ill pediatric patients; Interventions: We describe the use of CytoSorb in combination with standard therapy, continuous renal replacement therapy (CRRT) and plasmapheresis in ten severely ill pediatric patients with multiple organ failures of various etiologies; Measurements: The aim was to assess the effects on the inflammatory status, hemodynamics, and clinically relevant outcome parameters as well as the feasibility and safety of CytoSorb application in pediatrics; Main Results: We observed a marked decrease in inflammatory mediators, a reduction in catecholamine dosages and an improvement in organ functions, which was particularly pronounced in patients who survived. An early onset of treatment (at best within 24-48 hours after diagnosis of sepsis) seemed to be beneficial for eventual survival. Conclusions: The present case series is the first documentation of a set of pediatric/neonatal patients in which a combined therapeutic approach of hemoadsorption and renal replacement therapy showed promising results with regard to hemodynamic stabilization, control of the inflammatory response, improvement in organ functions as well as safety and feasibility. Further prospective randomized controlled studies in the pediatric field are necessary to elucidate the full potential of hemoadsorption in this set of patients.

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“…The application of Cytosorb was indicated as an adjuvant form of the sepsis treatment aimed at the nonselective removal of inflammatory mediators, the control of a strong inflammatory response and sepsis 3 . The success of the application of CytoSorb in patients with sepsis is described in the literature 6,7 . In the patient, a rapid haemodynamic stabilization was observed,with the reduction of vasopressors and inotropes dosage, within a few hours from the onset of the application of CytoSorb, as well as the reduction of inflammation markers.…”

Section: Discussionmentioning

confidence: 99%

Sepsis monitoring and therapy focus according to the individual needs of patients – case report

et al. 2017

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Abstract. Aim: Treatment and monitoring of the septic patient with individual approach applying Surviving sepsis campaign (SSC) recommendations, extracorporeal blood purification and cerebral oximetry monitoring. Case report: This is a case report of a female patient with clinical signs of septic shock and with multiple organ failure (renal, respiratory failure, hypotension, coagulation disorder, impairment of consciousness) in wich, in addition to standard treatment measures, extracorporeal blood purification (CytoSorb® -CytoSorbents Corporation and CytoSorbents Medical Inc., United States) was applied. After the completion of the hospital treatment, the patient was discharged to home treatment. Conclusion: Control of hyperinflammatory response using extracorporeal blood purification and cerebral oximetry monitoring may be, in special cases -applying Surviving sepsis campaign (SSC) recommendations -option for individual approach in sepsis management and following multiorgan dysfunction management.Key words: critical care; multiple organ failure; purification Sažetak. Cilj: Liječenje i nadzor pacijentice sa sepsom prema individualnom pristupu u kojem je, uz preporuke SSC-a, primijenjena i ekstrakorporalna purifikacija krvi, a u nadzoru cerebralna oksimetrija. Prikaz slučaja: Ovo je prikaz slučaja pacijentice s kliničkim znakovima septičkog šoka i višestrukim zatajenjem organa (bubrezi, zatajenje disanja, poremećaj zgrušavanja, poremećaj svijesti), u kojem je, u dodatku standardnih mjera liječenja, primijenjena izvantjelesna purifikacija krvi (CytoSorb® -CytoSorbents Corporation and CytoSorbents Medical Inc., United States). Nakon završetka bolničkog liječenja pacijentica je otpuštena na kućno liječenje. Zaključak: Kontrola hiperinflamacijskog odgovora primjenom ekstrakorporalne purifikacije krvi i nadzor cerebralnom oksimetrijom mogu u pojedinim slučajevima biti -uz primjenu Međunarodnih smjernica o liječenju sepse -opcija individualnog pristupa nadzora i liječenja sepse i prateće multiorganske disfunkcije.

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

Cited by 48 publications

References 8 publications

Use of Hemoadsorption in a Case of Severe Hepatic Failure and Hyperbilirubinemia

Use of Hemoadsorption in a Case of Severe Hepatic Failure and Hyperbilirubinemia

Application of Hemoadsorption in Neonatal and Pediatric Hyperinflammatory States: A Case Series

Sepsis monitoring and therapy focus according to the individual needs of patients – case report

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