Clinical Utility of Extracorporeal Cytokine Hemoadsorption Therapy: A Literature Review

Abstract

Cytokines play a critical role in coordinating and amplifying a host immune response to infection. The normal pattern of localized and systemic release of proinflammatory and anti-inflammatory cytokines varies on the basis of the disease process. A dysregulated cytokine response can lead to a hyper-inflammatory condition called a cytokine storm. This is believed to contribute to the pathophysiology of sepsis and septic shock, a condition carrying high morbidity and mortality in critically ill patients. Extracorporeal cytokine hemoadsorption is an emerging technology utilized in the treatment of dysregulated inflammatory states such as sepsis, although there is a paucity of clinical evidence supporting its outcomes benefits. We assess the peer-reviewed literature relating to cytokine hemoadsorption in the context of sepsis and suggest areas of future research incorporating this novel technology.

Sequential Extracorporeal Therapy Collaborative Device and Timely Support for Endotoxic, Septic, and Cardiac Shock: A Case Report

“…For this reason, Cytosorb was integrated to extracorporeal life support with ECMO for 48 h. Incorporation of the adsorber device into the ECMO circuit [25] was performed with the aim to reduce excessive levels of inflammatory molecules such as interleukins and cytokines and pathogen-associated molecular patterns. In available literature, extracorporeal blood purification using Cyto-Sorb ® has been shown to normalize serum cytokine levels in patients with sepsis and septic shock, although this has not consistently translated to improved patient outcomes [26], as we observed in this patient within 24 h of treatment (Fig. 1).…”

Hemostasis Management of Patients Undergoing Emergency Cardiac Surgery After Ticagrelor Loading

“…Cytosorb has not been approved for clinical use in the United States, but currently it is used in Europe as part of the anti-inflammatory regimen in sepsis and during extracorporeal circulation. 61 In summary, the current strategies to prevent or mitigate perioperative hemorrhage in ticagrelor-treated patients presenting for urgent/emergency cardiac surgery are highlighted in this case report. The use of PFT is an essential step to assess potential bleeding risk and optimize the timing of surgery.…”

Cardiac depression in severe acute pancreatitis: development mechanisms and possible treatment approaches. Review

“…Одно из исследований гемодинамических показателей при тяжелом ОП подтверждает гипотезу о действии цитокинов на миокард при сепсисе и тяжелом ОП: концентрация интерлейкина-6 по его результатам имеет корреляцию с гемодинамическими нарушениями при деструктивном панкреатите [3]. Удаление из плазмы цитокинов при ОП путем гемосорбции в результате ряда экспериментов приводило к быстрому улучшению состояния пациента и стабилизации гемодинамики [14][15][16][17], что может свидетельствовать об их важной роли в патогенезе КД.…”