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

Pancani, Flavia; Pavani, Raffaella; Quacquarelli, Antonio; Feri, Marco

doi:10.1177/03913988211016473

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…This is characterized by increased inflammatory cytokines and biomarkers like IL-2, IL-6, IL-7, macrophage inflammatory protein 1-α, TNF-α, GCSF, ferritin, pro-B-type natriuretic peptide (Pro-BNP), C-reactive protein (CRP) and D-dimer [20]. Specifically, COVID-19 leads to a drastic increase in IL-6 [21] which is the significant driver of ARDS and immune dysregulation [22]. Recently published study by Rieder et al reported significant reduction in IL-6 levels post CytoSorb ® therapy for COVID-19 patients [23].…”

Section: Discussionmentioning

confidence: 99%

CytoSorb® in the Treatment of Severely-Ill Patient with Post-COVID-19 Complications: A Case Report

Paul¹,

MA²,

Gorla³

et al. 2022

CCR

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Background: COVID-19 affects the respiratory tract leading to acute respiratory distress syndrome (ARDS) and serious pneumonia. Severe cases of COVID-19 are associated with hyperactive immune response characterized by the release of interleukins, interferons, chemokines, tumor-necrosis factors, and various other mediators. Use of CytoSorb ® , an extracorporeal hemadsorption has been observed to alleviate the cytokine storm, hence ameliorate the pulmonary function and hemodynamic stability. Case Summary: A 42-year-old man, a case of post-COVID-19 pneumonia was admitted in hospital with the complaints of headache, vomiting, and abdominal discomfort associated with generalized weakness. He had pre-existing comorbidities of diabetes, hypertension, and acute kidney injury. The blood parameters showed increased levels of inflammatory biomarkers which indicated the presence of cytokine storm and sepsis. The patient was given CytoSorb ® therapy after 7 days of admission in ICU in two sessions of 18 and 20 hours using two separate devices at the interval of 6 hours. After the treatment, remarkable decreased in CRP values (39%), S. Creatinine (6.52%), S. Lactate (54%), leucocytes (44%) and PCT (33%) was observed. A reduction in IL-6 levels (from 5975 to 3171 pg/ml, 46.9%) and norepinephrine dose (from 8 to 0.2 mcg/kg/hr, 25%) was reported. The patient was discharged from hospital in 54 days in stable condition. Conclusion: CytoSorb ® therapy was effective in providing hemodynamic stability, improving organ dysfunction, and modulating the cytokine storm.

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Section: Discussionmentioning

confidence: 99%

CytoSorb® in the Treatment of Severely-Ill Patient with Post-COVID-19 Complications: A Case Report

Paul¹,

MA²,

Gorla³

et al. 2022

CCR

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“…34 Another published study stated the use of new extracorporeal (EC) organ support therapies, including hemoadsorption and hemoperfusion, to manage sepsis patients with COVID-19. 35 Expert recommendations on blood purification strategies in managing COVID-19 suggest cytokine filtration as adjuvant therapy. In its interim decision, US FDA authorized CytoSorb ® by giving the EUA to treat patients more than 18-year-old with a confirmed diagnosis of COVID-19 in ICU with imminent respiratory failure to reduce pro-inflammatory cytokine levels.…”

Section: Coronavirus Disease 2019 and Cytosorb®mentioning

confidence: 99%

Hemoadsorption (CytoSorb®) in Management of Cytokine Storm and Implication in COVID-19 Pandemic

Prasad¹,

Mishra²,

Maheshwarappa³

et al. 2022

Journal of Acute Care

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Cytokines are a varied group of proteins released by our immune system and play an essential role in normal immune responses. There are different cytokines, including chemokines, interferons, interleukins (IL), lymphokines, and tumor necrosis factor (TNF). The primary functions of cytokines include inflammatory response, angiogenesis, down and upregulation of receptors, and control of cell differentiation. 5 However, in response to a severe immune reaction, many cytokines are released into the bloodstream. This sudden increase in cytokines is known as a cytokine storm. 5 It can be severe or IntroductIonAn estimated 48.9 million incident cases of sepsis were registered in 2017, with sepsis accounting for 19.7% of all global deaths. India contributed 11.3 million of these sepsis cases in 2017. Sepsis-related age-standardized incidence is 992/100,000 population. 1 The mortality rate with severe sepsis is about 30% in the Indian population. With low and mid-socioeconomic countries contributing to the doubling of sepsis globally in the last decade, a need for early diagnosis and treatment needs no emphasis. Newer insights into the pathophysiology of sepsis revolve around the imbalance in inflammatory mediators. 2 Cytokines act as mediators that are pivotal in the pathophysiology of sepsis. 3 Therapy to reduce, block, and filter cytokines continue to lure intensive care physicians around the globe. The present SARS-CoV-2 infection has generated interest for cytokine therapies in its management. 4 MaterIals a n d MethodsWe performed a literature review on the use of cytokine hemoadsorption therapies in Indian patients and looked at the clinical implications of such therapies in the current COVID-19 pandemic. An extensive literature search was done for keywords "hemoadsorption" and "CytoSorb®" using PubMed and Google Scholar search engines. All manuscripts with patients at Indian centers enrolled. We extend our review of cytokine storm in COVID-19 and the utility of CytoSorb® as an adjuvant in the management of septic shock in COVID-19.

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“…However, the limited understanding of specific inflammatory responses in different pathologies and complex networks of inflammatory responses are insufficient to control the overall inflammatory response. For instance, sepsis-like syndromes may also occur due to viral per se or superimposed bacterial infections (37). Unfortunately, microorganisms cannot be identified in up to one-third of the cultures, which will hinder the timely initiation of appropriate antibiotic therapy (38).…”

Section: Introductionmentioning

confidence: 99%

Effect of extracorporeal hemoadsorption in critically ill patients with COVID-19: A narrative review

Chang

Qin

et al. 2023

Front. Immunol.

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COVID-19 has been affecting the world unprecedentedly and will remain widely prevalent due to its elusive pathophysiological mechanism and the continuous emergence of new variants. Critically ill patients with COVID-19 are commonly associated with cytokine storm, multiple organ dysfunction, and high mortality. To date, growing evidence has shown that extracorporeal hemoadsorption can exert its adjuvant effect to standard of care by regulating immune homeostasis, reducing viremia, and decreasing endotoxin activity in critically ill COVID-19 cases. However, the selection of various hemofilters, timing of initiation and termination of hemoadsorption therapy, anticoagulation management of extracorporeal circuits, identification of target subgroups, and ultimate survival benefit remain controversial. The purpose of this narrative review is to comprehensively summarize the rationale for the use of hemoadsorption in critically ill patients with COVID-19 and to gather the latest clinical evidence in this field.

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

Cited by 4 publications

References 19 publications

CytoSorb® in the Treatment of Severely-Ill Patient with Post-COVID-19 Complications: A Case Report

CytoSorb® in the Treatment of Severely-Ill Patient with Post-COVID-19 Complications: A Case Report

Hemoadsorption (CytoSorb®) in Management of Cytokine Storm and Implication in COVID-19 Pandemic

Effect of extracorporeal hemoadsorption in critically ill patients with COVID-19: A narrative review

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