First successful hemoadsorption using CytoSorb<sup>®</sup> in a septic pediatric patient in Kazakhstan: A case report

Saparov, Askhat; Sazonov, Vitaliy; Тобылбаева, З. С.; Isakov, Samat; Бекпан, А. Ж.; Autalipov, Darkhan; Muratbekova, Bakhyt; Manaybekova, Zhazira; Anikin, Vitaliy

doi:10.1177/0391398818819953

Cited by 10 publications

(24 citation statements)

References 6 publications

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“…Our previous experience with CytoSorb showed a 32% reduction rate of IL-6 (22). Here, HA330 appeared to be more effective in eliminating IL-6 from the bloodstream compared to CytoSorb.…”

Section: Discussionmentioning

confidence: 62%

Case Series: Efficacy and Safety of Hemoadsorption With HA-330 Adsorber in Septic Pediatric Patients With Cancer

et al. 2021

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Background: Sepsis is a frequent cause of death in hospitalized patients and, in detail, in neonatal, pediatric, and adult intensive care units (ICUs). Severe sepsis has a very poor prognosis. Indeed, the mortality rate varies between 30 and 70% during the first 7–14 days. Despite a timely and appropriate therapy, the prognosis of severe sepsis is too often negative. Therefore, new therapeutic resources are under investigation in order to further improve prognosis.Case series: Here, we reported three septic children in whom we used extracorporeal blood purification therapy with hemoadsorption device HA330 (Jafron Biomedical Co., Ltd., China), aiming to scavenge and eliminate bacterial toxins and inflammatory mediators from the blood.Discussion and Conclusion: This small case series first showed that hemoperfusion with HA330 cartridge may be an effective and relatively safe adjunctive treatment to counterbalance the cytokine storm in septic children with hematological disorders. Further studies are needed to confirm and further support its safety and efficacy in a large number of pediatric patients.

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“…Our previous experience with CytoSorb showed a 32% reduction rate of IL-6 (22). Here, HA330 appeared to be more effective in eliminating IL-6 from the bloodstream compared to CytoSorb.…”

Section: Discussionmentioning

confidence: 62%

Case Series: Efficacy and Safety of Hemoadsorption With HA-330 Adsorber in Septic Pediatric Patients With Cancer

et al. 2021

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“…When comparing risk-adjusted hospital mortality rates (observed-to-expected mortality ratios, short: O/E ratios), no significant difference between the groups was found: 0.88 (95% CI 0.77-0.99) vs. 0.80 (95% CI 0.65-0.94). With regard to the use of haemoadsorption cartridges in survivors, approximately one cartridge per patient was utilised as the median (IQR 1, 2) for 35.5 h (17,47).…”

Section: Resultsmentioning

confidence: 99%

“…With regard to the current literature on haemoadsorption, it would seem reasonable and associated only with the slightest logistics to add Cytosorb ™ to the RRT in septic patients with ARF for haemoadsorption. However, no study has yet prospectively analysed patients in septic shock with sepsis-associated acute kidney injury (SA-AKI) [6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Until now, only case reports/ series and retrospective studies have supported in their findings the utilisation of the absorber we used in this study [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Adsorption therapy in critically ill with septic shock and acute kidney injury: a retrospective and prospective cohort study

Schittek

Zoidl

Eichinger

et al. 2020

Ann. Intensive Care

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Background Haemoadsorption has been described as an effective way to control increased pro- and anti-inflammatory mediators (“cytokine storm”) in septic shock patients. No prospective or randomised clinical study has yet confirmed these results. However, no study has yet prospectively specifically investigated patients in severe septic shock with sepsis-associated acute kidney injury (SA-AKI). Therefore, we aimed to examine whether haemoadsorption could influence intensive care unit (ICU) and hospital mortality in these patients. Furthermore, we examined the influence of haemoadsorption on length of stay in the ICU and therapeutic support. Methods Retrospective control group and prospective intervention group design in a tertiary hospital in central Europe (Germany). Intervention was the implementation of haemoadsorption for patients in septic shock with SA-AKI. 76 patients were included in this analysis. Results Severity of illness as depicted by APACHE II was higher in patients treated with haemoadsorption. Risk-adjusted ICU mortality rates (O/E ratios) did not differ significantly between the groups (0.80 vs. 0.83). We observed in patients treated with haemoadsorption a shorter LOS and shorter therapeutic support such as catecholamine dependency and duration of RRT. However, in multivariate analysis (logistic regression for mortality, competing risk for LOS), we found no significant differences between the two groups. Conclusions The implementation of haemoadsorption for patients in septic shock with acute renal failure did not lead to a reduction in ICU or hospital mortality rates. Despite univariate analysis delivering some evidence for a shorter duration of ICU-related treatments in the haemoadsorption group, these results did not remain significant in multivariate analysis. Trial registration CytoSorb® registry https://clinicaltrials.gov/ct2/show/NCT02312024. December 9, 2014. Database: https://www.cytosorb-registry.org/ (registration for content acquisition is necessary)

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“…WHO has introduced CytoSorb in the list of DOI: 10.1159/000509677 experimental treatments in COVID-19 patients [52]. Only few reports on critically ill (non-COVID-19) children have described this therapy as safe and potentially effective [53][54][55]. In the opinion of the authors, at the moment, this therapy would require further evaluation in COVID-19 children.…”

Section: Other Extracorporeal Therapiesmentioning

confidence: 99%

Acute Kidney Injury and Special Considerations during Renal Replacement Therapy in Children with Coronavirus Disease-19: Perspective from the Critical Care Nephrology Section of the European Society of Paediatric and Neonatal Intensive Care

2020

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Children seem to be less severely affected by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) as compared to adults. Little is known about the prevalence and pathogenesis of acute kidney injury (AKI) in children affected by SARS-CoV-2. Dehydration seems to be the most common trigger factor, and meticulous attention to fluid status is imperative. The principles of initiation, prescription, and complications related to renal replacement therapy are the same for coronavirus disease (COVID) patients as for non-COVID patients. Continuous renal replacement therapy (CRRT) remains the most common modality of treatment. When to initiate and what modality to use are dependent on the available resources. Though children are less often and less severely affected, diversion of all hospital resources to manage the adult surge might lead to limited CRRT resources. We describe how these shortages might be mitigated. Where machines are limited, one CRRT machine can be used for multiple patients, providing a limited number of hours of CRRT per day. In this case, increased exchange rates can be used to compensate for the decreased duration of CRRT. If consumables are limited, lower doses of CRRT (15–20 mL/kg/h) for 24 h may be feasible. Hypercoagulability leading to frequent filter clotting is an important issue in these children. Increased doses of unfractionated heparin, combination of heparin and regional citrate anticoagulation, or combination of prostacyclin and heparin might be used. If infusion pumps to deliver anticoagulants are limited, the administration of low-molecular-weight heparin might be considered. Alternatively in children, acute peritoneal dialysis can successfully control both fluid and metabolic disturbances. Intermittent hemodialysis can also be used in patients who are hemodynamically stable. The keys to successfully managing pediatric AKI in a pandemic are flexible use of resources, good understanding of dialysis techniques, and teamwork.

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First successful hemoadsorption using CytoSorb^® in a septic pediatric patient in Kazakhstan: A case report

Cited by 10 publications

References 6 publications

Case Series: Efficacy and Safety of Hemoadsorption With HA-330 Adsorber in Septic Pediatric Patients With Cancer

Case Series: Efficacy and Safety of Hemoadsorption With HA-330 Adsorber in Septic Pediatric Patients With Cancer

Adsorption therapy in critically ill with septic shock and acute kidney injury: a retrospective and prospective cohort study

Acute Kidney Injury and Special Considerations during Renal Replacement Therapy in Children with Coronavirus Disease-19: Perspective from the Critical Care Nephrology Section of the European Society of Paediatric and Neonatal Intensive Care

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First successful hemoadsorption using CytoSorb® in a septic pediatric patient in Kazakhstan: A case report

Cited by 10 publications

References 6 publications

Case Series: Efficacy and Safety of Hemoadsorption With HA-330 Adsorber in Septic Pediatric Patients With Cancer

Case Series: Efficacy and Safety of Hemoadsorption With HA-330 Adsorber in Septic Pediatric Patients With Cancer

Adsorption therapy in critically ill with septic shock and acute kidney injury: a retrospective and prospective cohort study

Acute Kidney Injury and Special Considerations during Renal Replacement Therapy in Children with Coronavirus Disease-19: Perspective from the Critical Care Nephrology Section of the European Society of Paediatric and Neonatal Intensive Care

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First successful hemoadsorption using CytoSorb^® in a septic pediatric patient in Kazakhstan: A case report