Hemoadsorption in Infection‐Associated Rhabdomyolysis

Suefke, Sven; Sayk, Friedhelm; Nitschke, Martin

doi:10.1111/1744-9987.12410

Cited by 9 publications

(8 citation statements)

References 4 publications

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“…To date, CytoSorb has also been successfully applied in patients with post-cardiopulmonary bypass systemic inflammatory response syndrome (SIRS) [17], rhabdomyolysis-associated myoglobinemia [18] and in liver failure [19]. Along with the effective removal of inflammatory mediators, the most prominent effect observed with the use of CytoSorb is the improvement in hemodynamics accompanied by a reduction in vasopressor doses.…”

Section: Introductionmentioning

confidence: 99%

Hemoadsorption by CytoSorb in septic patients: a case series

et al. 2017

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BackgroundSeptic shock, defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, is a highly lethal condition that causes substantial morbidity and mortality among critically ill patients. One of the hallmarks of sepsis is the excessive release of cytokines and other inflammatory mediators causing refractory hypotension, tissue damage, metabolic acidosis and ultimately multiple organ failure. In this context, cytokine reduction by hemoadsorption represents a new concept for blood purification, developed to attenuate the overwhelming systemic levels of pro-inflammatory and anti-inflammatory mediators released in the early phase of sepsis.MethodsIn the present case series, we evaluated the impact of a new hemoadsorption device (CytoSorb) used as adjunctive therapy, on hemodynamics and clinically relevant outcome parameters in 26 critically ill patients with septic shock and in need of renal replacement therapy.ResultsWe found that treatment of these patients with septic shock was associated with hemodynamic stabilization and a reduction in blood lactate levels. Actual mortality in the overall patient population was lower than mortality predicted by acute physiology and chronic health evaluation II (APACHE II). These effects seem to be more pronounced in patients in whom therapy started within 24 h of sepsis diagnosis, whereas a delay in the start of therapy was associated with a poor response to therapy in terms of reduction of catecholamine demand and survival. Moreover, from our patient population, medical patients seemed to benefit more than post-surgical patients in terms of survival. Treatment using the CytoSorb device was safe and well-tolerated with no device-related adverse events during or after the treatment sessions.ConclusionHemoadsorption using CytoSorb resulted in rapid hemodynamic stabilization and increased survival, particularly in patients in whom therapy was started early. Given the positive clinical experience of this case series, randomized controlled trials are urgently needed to define the potential benefits of this new treatment option.

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Section: Introductionmentioning

confidence: 99%

Hemoadsorption by CytoSorb in septic patients: a case series

et al. 2017

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“…12 CytoSorb ® has been successfully used in patients with septic shock, post-cardiopulmonary bypass systemic inflammatory response syndrome (SIRS), 13 in liver failure, 14 and rhabdomyolysis-associated myoglobinemia. 15 The most effective results were obtained in the treatment of hemodynamics accompanied by a decrease in vasopressor doses. 10 CytoSorb ® physicochemically (hydrophobic molecules with a molecular weight of up to approximately 55 kDa) binds with selective substances.…”

Section: Discussionmentioning

confidence: 99%

Hemoadsorption by extracorporeal cytokine adsorption therapy (CytoSorb^®) in the management of septic shock: A retrospective observational study

et al. 2019

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Introduction: Sepsis results in immunologic disturbances with the release of various inflammatory mediators such as cytokines. Cytokines can damage the cells, and the continuous release of inflammatory mediators leads to severely impaired immunity. Therefore, the reduction in cytokine levels by hemoadsorption represents a new concept for blood purification. CytoSorb® as a hemoadsorption device is a detoxification system, which aims to decrease the cytokines levels. This study was conducted to understand any beneficial effects of CytoSorb® therapy in septic patients. Methodology: This was a retrospective and observational study, approved by the scientific and ethics committee of Max Super Specialty Hospital, Patparganj, Delhi, India and conducted in compliance with current International Council for Harmonization, Good Clinical Practice, Schedule Y, and Indian Council of Medical Research guidelines. Subjects of either gender (age > 18 year) were included in the study. The data were presented as mean ± standard deviation and categorical as frequency and percentage (%). A p value less than 0.05 (p < 0.05) was considered to be statistically significant. Results: A total number of 36 patients were included in the study. Majority of the patients were male with mean age (56.36 ± 14.83). After therapy, procalcitonin and total leucocyte count levels decreased within 24 h. Post therapy, sepsis-related organ failure assessment (SOFA) score of Day (D)1, D2, and D3 reduced to 10.4 ± 3.63, 8.7 ± 4.02, and 7.8 ± 3.67, respectively. The Acute Physiology and Chronic Health Evaluation (APACHE) II score and predicted mortality were lower in the survivor group as compared to the non-survivor group. Conclusion: Hemoadsorption using the extracorporeal adsorption device (CytoSorb®) might be an effective rescue therapy in stabilizing septic shock patients.

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“…In the present case, we successfully treated a patient suffering from severe rhabdomyolysis after heart transplantation with extracorporeal cytokine adsorption and were able to preserve his renal function. Although cytokine adsorption was able to decrease the CK and myoglobin concentration, 4 its beneficial effects in the case of cardiac surgery as well as heart transplantation remain uncertain 5 . Furthermore, it removes antibiotics and immunosuppressive drugs such as tacrolimus, which may cause severe adverse side effects in heart transplant patients 5 .…”

Section: Case Reportmentioning

confidence: 99%

“…Rhabdomyolysis is characterized by tremendously high levels of serum creatine kinase (CK) and myoglobin leading to kidney failure. Newly developed hemoadsorption devices are able to treat the side effects of rhabdomyolysis by decreasing CK and myoglobin concentration in the serum 4 . However, due to their nonspecific adsorption spectrum, these devices may also adsorb unknown concentrations of potential beneficial plasma ingredients as well as drugs such as antibiotics and immunosuppressive drugs.…”

Section: Introductionmentioning

confidence: 99%

“…Newly developed hemoadsorption devices are able to treat the side effects of rhabdomyolysis by decreasing CK and myoglobin concentration in the serum. 4 However, due to their nonspecific adsorption spectrum, these devices may also adsorb unknown concentrations of potential beneficial plasma ingredients as well as drugs such as antibiotics and immunosuppressive drugs. Here, we present, to the best of our knowledge, the first case report of a heart transplant recipient who developed severe rhabdomyolysis that was successfully treated using a hemoadsorption device.…”

Section: Introductionmentioning

confidence: 99%

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Succesful treatment of a severe case of rhabdomyolysis following heart transplantation by hemoadsorption

et al. 2020

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Patients after heart transplantation are often showing a variety of different perioperative complications causing an impaired outcome. Rhabdomyolysis can be caused by several reasons such as limb ischemia or myocardial damage and become a trigger for kidney injury. Chronic renal failure with the need for hemodialysis remains a common problem after transplantation and impacts post‐transplant survival. We describe the successful treatment of a patient with severe rhabdomyolysis following heart transplantation by the usage of hemoadsorption.

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Hemoadsorption in Infection‐Associated Rhabdomyolysis

Cited by 9 publications

References 4 publications

Hemoadsorption by CytoSorb in septic patients: a case series

Hemoadsorption by CytoSorb in septic patients: a case series

Hemoadsorption by extracorporeal cytokine adsorption therapy (CytoSorb^®) in the management of septic shock: A retrospective observational study

Succesful treatment of a severe case of rhabdomyolysis following heart transplantation by hemoadsorption

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Hemoadsorption in Infection‐Associated Rhabdomyolysis

Cited by 9 publications

References 4 publications

Hemoadsorption by CytoSorb in septic patients: a case series

Hemoadsorption by CytoSorb in septic patients: a case series

Hemoadsorption by extracorporeal cytokine adsorption therapy (CytoSorb®) in the management of septic shock: A retrospective observational study

Succesful treatment of a severe case of rhabdomyolysis following heart transplantation by hemoadsorption

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Hemoadsorption by extracorporeal cytokine adsorption therapy (CytoSorb^®) in the management of septic shock: A retrospective observational study