Hämoadsorption zur Blutreinigung – Unvergleichbarkeit der klinisch angebotenen Verfahren

Krenn, C.-G.; Steltzer, H.

doi:10.1007/s00063-020-00702-2

Cited by 7 publications

(3 citation statements)

References 20 publications

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“…Another limitation is that we only evaluated one hemoadsorption device. Although there are other hemoadsorbers on the market (Jafron, Jafron Biomedical Co., Guangdong, China; Biosky, Biosun Medical Technology Co., Foshan, China), published data are extremely scarce in general, and none are available in the current context of hemodynamic stabilization, as was nicely summarized in a recently published review by Krenn and Stelzer [93]. Finally, we cannot make any comments on either shock reversal-as data on metabolic changes are missing-or on other beneficial effects on outcome, including survival.…”

Section: Discussionmentioning

confidence: 99%

The Potential Role of Extracorporeal Cytokine Removal in Hemodynamic Stabilization in Hyperinflammatory Shock

et al. 2021

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Hemodynamic instability due to dysregulated host response is a life-threatening condition requiring vasopressors and vital organ support. Hemoadsorption with Cytosorb has proven to be effective in reducing cytokines and possibly in attenuating the devastating effects of the cytokine storm originating from the immune over-response to the initial insult. We reviewed the PubMed database to assess evidence of the impact of Cytosorb on norepinephrine needs in the critically ill. We further analyzed those studies including data on control cohorts in a comparative pooled analysis, defining a treatment effect as the standardized mean differences in relative reductions in vasopressor dosage at 24 h. The literature search returned 33 eligible studies. We found evidence of a significant reduction in norepinephrine requirement after treatment: median before, 0.55 (IQR: 0.39–0.90); after, 0.09 (0.00–0.25) μg/kg/min, p <0.001. The pooled effect size at 24 h was large, though characterized by high heterogeneity. In light of the importance of a quick resolution of hemodynamic instability in the critically ill, further research is encouraged to enrich knowledge on the potentials of the therapy.

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Section: Discussionmentioning

confidence: 99%

The Potential Role of Extracorporeal Cytokine Removal in Hemodynamic Stabilization in Hyperinflammatory Shock

et al. 2021

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“…So better guidance in regard to patient selection, timing and dosing has to compiled and provided to the user at the bedside. Importantly and with regard to the different ECT systems available in the market, it has to be stated that clinical results, but particularly safety relevant aspects, are not transferable between various hemoadsorption products due to technical differences[ 104 ].…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal blood purification strategies in sepsis and septic shock: An insight into recent advancements

Mehta¹,

Paul²,

Ansari³

et al. 2023

World J Crit Care Med

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BACKGROUND Despite various therapies to treat sepsis, it is one of the leading causes of mortality in the intensive care unit patients globally. Knowledge about the pathophysiology of sepsis has sparked interest in extracorporeal therapies (ECT) which are intended to balance the dysregulation of the immune system by removing excessive levels of inflammatory mediators. AIM To review recent data on the use of ECT in sepsis and to assess their effects on various inflammatory and clinical outcomes. METHODS In this review, an extensive English literature search was conducted from the last two decades to identify the use of ECT in sepsis. A total of 68 articles from peer-reviewed and indexed journals were selected excluding publications with only abstracts. RESULTS Results showed that ECT techniques such as high-volume hemofiltration, coupled plasma adsorption/filtration, resin or polymer adsorbers, and CytoSorb ® are emerging as adjunct therapies to improve hemodynamic stability in sepsis. CytoSorb ® has the most published data in regard to the use in the field of septic shock with reports on improved survival rates and lowered sequential organ failure assessment scores, lactate levels, total leucocyte count, platelet count, interleukin- IL-6, IL-10, and TNF levels. CONCLUSION Clinical acceptance of ECT in sepsis and septic shock is currently still limited due to a lack of large random clinical trials. In addition to patient-tailored therapies, future research developments with therapies targeting the cellular level of the immune response are expected.

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“…However, despite considerable advances in its management, most sepsis trials investigating promising technologies and drugs that modulate the inflammatory response have failed in the past to produce convincing results [4]. One of the potential adjunctive therapies is extracorporeal hemoadsorption, of which the most studied platform is CytoSorb ® [7]. Notwithstanding considerable data that has been generated over the years, definitive evidence is still lacking, despite the increasing number of treatments worldwide.…”

Section: Introductionmentioning

confidence: 99%

Adjunctive Hemoadsorption Therapy with CytoSorb in Patients with Septic/Vasoplegic Shock: A Best Practice Consensus Statement

Mitzner,

Kogelmann,

Ince

et al. 2023

JCM

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A dysregulated host response is a common feature in critically ill patients due to both infectious and non-infectious origins that can lead to life-threatening organ dysfunction, which is still the primary cause of death in intensive care units worldwide. In its course, pathologic, unregulated levels of inflammatory mediators are often released into the circulation, a phenomenon also referred to as a “cytokine storm”. To date, there are no approved therapies to modulate the excessive immune response and limit hyperinflammation with the goal of preventing related organ failure and death. In this context, extracorporeal blood purification therapies aiming at the alteration of the host inflammatory response through broad-spectrum, non-selective removal of inflammatory mediators have come into focus. A novel hemoadsorption device (CytoSorb®, CytoSorbents Inc., Princeton, NJ, USA) has shown promising results in patients with hyperinflammation from various origins. Although a significant body of literature exists, there is ongoing research to address many important remaining questions, including the optimal selection of patient groups who might benefit the most, optimal timing for therapy initiation, optimal schedule for adsorber exchanges and therapy duration, as well as an investigation into the potential removal of concomitant antibiotics and other medications. In this review, we discuss the existing evidence and provide a consensus-based best practice guidance for CytoSorb® hemoadsorption therapy in patients with vasoplegic shock.

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Hämoadsorption zur Blutreinigung – Unvergleichbarkeit der klinisch angebotenen Verfahren

Cited by 7 publications

References 20 publications

The Potential Role of Extracorporeal Cytokine Removal in Hemodynamic Stabilization in Hyperinflammatory Shock

The Potential Role of Extracorporeal Cytokine Removal in Hemodynamic Stabilization in Hyperinflammatory Shock

Extracorporeal blood purification strategies in sepsis and septic shock: An insight into recent advancements

Adjunctive Hemoadsorption Therapy with CytoSorb in Patients with Septic/Vasoplegic Shock: A Best Practice Consensus Statement

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