Extracorporeal Elimination of Pro- and Anti-inflammatory Modulators by the Cytokine Adsorber CytoSorb® in Patients with Hyperinflammation: A Prospective Study

Autor: Helen Graf, Caroline Gräfe, Mathias Bruegel, Felix L. Happich, Vassilissa Wustrow, Aljoscha Wegener, Wolfgang Wilfert, Michael Zoller, Uwe Liebchen, Michael Paal, Christina Scharf
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Infectious Diseases and Therapy, Vol 13, Iss 9, Pp 2089-2101 (2024)
Druh dokumentu: article
ISSN: 2193-8229
2193-6382
DOI: 10.1007/s40121-024-01028-8
Popis: Abstract Introduction The release of pro-inflammatory cytokines in critically ill patients with sepsis leads to endothelial dysfunction resulting in cardiocirculatory insufficiency. Their extracorporeal elimination using the cytokine adsorber CytoSorb® (CS) (adsorption of especially hydrophobic molecules 500 pg/ml), continuous kidney replacement therapy, and the application of CS. Various cytokines and chemokines were measured pre- and post-CS as well as in patients’ blood at predefined timepoints. Significant changes in the concentrations were detected with the Wilcoxon test with associated samples. Clearance of the adsorber (ml/min) was calculated with: $$blood\,flow*\frac{{concentration\, \left( {pre - post} \right)}}{{concentration\, \left( {pre} \right)}}.$$ b l o o d f l o w ∗ c o n c e n t r a t i o n p r e - p o s t c o n c e n t r a t i o n pre . Results Most of the inflammatory mediators showed a high initial extracorporeal clearance of 70–100 ml/min after CS installation, which dropped quickly to 10-30 ml/min after 6 h of treatment. No difference in clearance was observed between pro- and anti-inflammatory cytokines. Despite extracorporeal adsorption, a significant (p
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