What Have We Learned about the Use of Cytosorb Adsorption Columns?

Abstract

Extracorporeal blood purification techniques have emerged and evolved in the recent years as a potential therapy for the purpose of immunomodulation in acute conditions like sepsis. Understanding the extent of immune system dysregulation involved in the pathophysiology of these conditions, resulted in the development of such treatment strategies aiming at restoring a balanced inflammatory response. Beyond conventional continuous renal replacement therapy, high volume hemofiltration, high cut-off membranes, adsorption alone and coupled plasma filtration adsorption are well-described techniques in the literature. The evidence to support their routine use, however, is conflicting and insufficient at this stage. Despite the low-quality level of evidence in favor of utilizing these techniques, studies to further explore their effectiveness, safety, and potential novel applications, continue to evolve. Our review aims at focusing on adsorption therapy, particularly using the adsorption columns Cystosorb.

Hemoadsorption Improves Survival of Rats Exposed to an Acutely Lethal Dose of Aflatoxin B1

“…Early hemoperfusion approaches to treat intoxication with modified charcoal have been reported to have undesirable effects on hemostasis and coagulation activity leading to their disuse 45 . In contrast, longer-term clinical studies (30-& 60-day) have established CS treatment to be safe and effective for a number of indications in critically ill patients 46 easing general concerns about disturbances to physiologic homeostasis through untoward removal of beneficial substances, however close drug level monitoring is essential as some antibiotics and other drugs are known to be adsorbed 47 .…”

Succesful treatment of a severe case of rhabdomyolysis following heart transplantation by hemoadsorption

“…In the present case, we successfully treated a patient suffering from severe rhabdomyolysis after heart transplantation with extracorporeal cytokine adsorption and were able to preserve his renal function. Although cytokine adsorption was able to decrease the CK and myoglobin concentration, 4 its beneficial effects in the case of cardiac surgery as well as heart transplantation remain uncertain 5 . Furthermore, it removes antibiotics and immunosuppressive drugs such as tacrolimus, which may cause severe adverse side effects in heart transplant patients 5 .…”

“…Although cytokine adsorption was able to decrease the CK and myoglobin concentration, 4 its beneficial effects in the case of cardiac surgery as well as heart transplantation remain uncertain 5 . Furthermore, it removes antibiotics and immunosuppressive drugs such as tacrolimus, which may cause severe adverse side effects in heart transplant patients 5 . Therefore, we carefully monitored the concentrations of different drugs in the plasma.…”

“…5 Furthermore, it removes antibiotics and immunosuppressive drugs such as tacrolimus, which may cause severe adverse side effects in heart transplant patients. 5 Therefore, we carefully monitored the concentrations of different drugs in the plasma. We did not observe any problems concerning pharmacokinetics.…”

Coronavirus Epidemic and Extracorporeal Therapies in Intensive Care: si vis pacem para bellum

“…The suggested scheme of application of HA380 cartridges (Jafron Biomedical Co., China) was 2-1-1, that is, 2 units utilized for 12 h in the first 24 h and 1 unit per day utilized for 24 h in the following 2 days. In Europe, we had matured some experience with the use of Cytosorb © cartridges (CytoSorbents Corporation, NJ, USA), exactly for the same purpose of controlling deadly inflammation in critically ill and cardiac surgery patients [27,28]. This approach may be just one of many others [29] utilizing extracorporeal therapies in these severe syndromes and will require scientific validation once the emergency of the current epidemic will be over.…”