Cytokine adsorption as a promising option for septic shock and multiple organ failure due to Candida infection and decompensated type 1 diabetes mellitus

Abstract

Type 1 diabetes mellitus (T1DM) represents one of the most common chronic diseases in childhood. It is associated with high morbidity and mortality rates due to metabolic dysregulation, immunosuppressive effects, and a predisposition to fungal infections. Candidiasis is a severe infection and its prevalence has increased throughout the last decades. We report the case of a 19-year-old female patient admitted to our intensive care unit with T1DM and Candida infection associated with severe metabolic acidosis. In the absence of response to high dose catecholamine cardiovascular therapy and the presence of severe metabolic acidosis, a CytoSorb cartridge was implemented into the extracorporeal dialysis circuit resulting in a stabilization of hemodynamics accompanied by a tremendous decrease in vasopressor requirements, control of the hyperinflammatory response, as well as a resolution of metabolic acidosis and regeneration of renal function. Treatment with CytoSorb was safe and feasible without technical problems. Notably, this is the first case description reporting on the effects of CytoSorb in a patient with Candida infection as part of T1DM.

Impact of CytoSorb on kinetics of vancomycin and bivalirudin in critically ill patients

“…A reduction of inotropes was a further marker of clinical efficacy. Use of this method was successful in treating a high number of patients who recovered from cardiogenic shock and from shock‐related organ failure, 14 and preliminary evidence of mortality reduction in patients in septic shock 2 was also reported in previous literature.…”

Continuous renal replacement therapy with the addition of CytoSorb cartridge in critically ill patients with COVID‐19 plus acute kidney injury: A case‐series

“…Although the CytoSorb cartridge was initially manufactured to remove cytokines, it has also shown the ability to remove pathogen-associated molecular pattern molecules (ie, bacterial exotoxins), and damage associated molecular pattern molecules. [81][82][83][84] In brief, as we continue the multi-pronged worldwide search for COVID-19 therapies, we should not rule out the combination of CRRT and hemoabsorption cartridges in life-threatening COVID-19 cases with AKI. Conceivably, the addition of hemoadsorption to CRRT or ECMO may expand their potential application in critically ill COVID-19 patients.…”

Blood purification during valve surgery for endocarditis in an adolescent

“…In contrast to our case, in other reports, patients treated were in refractory septic shock. [1][2] In present case, the young patient was initially hemodynamically stable, but he was at risk; on the one hand, he could develop a septic shock due to the endocarditis, and on the other hand, he could develop an additional inflammatory reaction due to the operation and CPB. He was on antibiotics but the organism was not identified.…”

“…To the Editor, Blood purification has an additional beneficial effect in the therapy of sepsis and septic shock through the effective reduction of endotoxins and cytokines. 1 This effect may decrease inflammation and avoid multi-organ failure. In most cases, the device was installed into the hemofiltration circuit of continuous renal placement therapy.…”

“…In most cases, the device was installed into the hemofiltration circuit of continuous renal placement therapy. [1][2] We report the case of an adolescent undergoing purification on cardiopulmonary bypass (CPB) during valve surgery for endocarditis. A 15-year old boy with history of bicuspid valve and mild aortic valve regurgitation suffered for a few days from abdominal pain, diarrhea, and vomiting.…”