High-dose CytoSorb hemoadsorption is associated with improved survival in patients with septic shock: A retrospective cohort study

Philipp Schultz, Elke Schwier, Claas Eickmeyer, Dietrich Henzler, Thomas Köhler

Producción científica: Contribución a una revistaArtículorevisión exhaustiva

42 Citas (Scopus)

Resumen

Background and purpose: Hemoadsorption with CytoSorb® offers a possible therapeutic approach in septic shock, but modes of application and dosing are still undetermined. Materials and methods: Data from surgical patients with septic shock, treated with hemoadsorption adjunctive to renal replacement therapy were analyzed retrospectively. The 28-day mortality was compared to predicted mortality. Results: In 70 patients (70.6 ± 13.3 years), hemoadsorption was applied for 85.6 ± 53.8 h. The APACHE ll (30.2 ± 6.3) calculated to a predicted mortality of 73.3%, while the observed mortality was significantly lower (50%, p < 0.05). The amount of blood purified was higher in survivors than in non-survivors (8.5 ± 4.4 vs. 6.1 ± 3.6 l/kgBW, p = 0.017). We identified three clusters of <6 l/kgBW, 6-13 l/kgBW and ≥ 13 l/kgBW with a linear dose-response relation between blood purification volume and survival, which was best in the highest volume cluster (83.3%; p = 0.045). Conclusions: The application of CytoSorb® seems to be effective in various conditions of septic shock. In a cohort of most severely ill patients the observed mortality was lower than predicted and decreased linearly with blood purification volumes inadvertently exceeding 6 l/kg BW. These results suggest that hemoadsorption might improve survival provided that the applied dose is high enough.

Idioma originalEnglish
Páginas (desde-hasta)184-192
Número de páginas9
PublicaciónJournal of Critical Care
Volumen64
DOI
EstadoPublished - ago. 2021
Publicado de forma externa

Nota bibliográfica

Funding Information:
PS and TK have received lecture fees from Cytosorbent Europe. The Department of Anesthesiology at Klinikum Herford has received an unrestricted research grant from Cytosorbent Europe in 2018.

Publisher Copyright:
© 2021 Elsevier Inc.

ASJC Scopus Subject Areas

  • Critical Care and Intensive Care Medicine

PubMed: MeSH publication types

  • Journal Article

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