Immunomodulation by Hemoadsorption—Changes in Hepatic Biotransformation Capacity in Sepsis and Septic Shock: A Prospective Study

Janina Praxenthaler; Elke Schwier; Simon Altmann; Carmen Kirchner; Julian Bialas; Dietrich Henzler; Thomas Köhler

doi:10.3390/biomedicines10102340

Immunomodulation by Hemoadsorption—Changes in Hepatic Biotransformation Capacity in Sepsis and Septic Shock: A Prospective Study

Janina Praxenthaler, Elke Schwier, Simon Altmann, Carmen Kirchner, Julian Bialas, Dietrich Henzler, Thomas Köhler

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2 Citas (Scopus)

Resumen

Background: Sepsis is often associated with liver dysfunction, which is an indicator of poor outcomes. Specific diagnostic tools that detect hepatic dysfunction in its early stages are scarce. So far, the immune modulatory effects of hemoadsorption with CytoSorb^® on liver function are unclear. Method: We assessed the hepatic function by using the dynamic LiMAx^® test and biochemical parameters in 21 patients with sepsis or septic shock receiving CytoSorb^® in a prospective, observational study. Points of measurement: T₁: diagnosis of sepsis or septic shock; T₂ and T₃: 24 h and 48 h after the start of CytoSorb^®; T₄: 24 h after termination of CytoSorb^®. Results: The hepatic biotransformation capacity measured by LiMAx^® was severely impaired in up to 95 % of patients. Despite a rapid shock reversal under CytoSorb^®, a significant improvement in LiMAx^® values appeared from T₃ to T₄. This decline and recovery of liver function were not reflected by common parameters of hepatic metabolism that remained mostly within the normal range. Conclusions: Hepatic dysfunction can effectively and safely be diagnosed with LiMAx^® in ventilated ICU patients under CytoSorb^®. Various static liver parameters are of limited use since they do not adequately reflect hepatic dysfunction and impaired hepatic metabolism.

Idioma original	English
Número de artículo	2340
Publicación	Biomedicines
Volumen	10
N.º	10
DOI	https://doi.org/10.3390/biomedicines10102340
Estado	Published - oct. 2022
Publicado de forma externa	Sí

Nota bibliográfica

Funding Information:
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The study was partially funded (consumables) by intramural funds from the Faculty of Medicine, Ruhr-University Bochum.

Funding Information:
TK had received lecture fees from Cytosorbent Europe. The Department of Anesthesiology at Klinikum Herford received an unrestricted research grant from Cytosorbent Europe in 2018. The authors declare that they have no other competing interests.

Funding Information:
The authors would like to thank all dedicated doctors and nurses of the intensive care unit, who were involved in the clinical treatment of these challenging patients. Special thanks to Stephanie Erbe for the accurate data collection. We acknowledge support by the Open Access Publication Funds of the Ruhr-Universität Bochum.

Publisher Copyright:
© 2022 by the authors.

ASJC Scopus Subject Areas

Medicine (miscellaneous)
General Biochemistry,Genetics and Molecular Biology

PubMed: MeSH publication types

Journal Article

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title = "Immunomodulation by Hemoadsorption—Changes in Hepatic Biotransformation Capacity in Sepsis and Septic Shock: A Prospective Study",

abstract = "Background: Sepsis is often associated with liver dysfunction, which is an indicator of poor outcomes. Specific diagnostic tools that detect hepatic dysfunction in its early stages are scarce. So far, the immune modulatory effects of hemoadsorption with CytoSorb{\textregistered} on liver function are unclear. Method: We assessed the hepatic function by using the dynamic LiMAx{\textregistered} test and biochemical parameters in 21 patients with sepsis or septic shock receiving CytoSorb{\textregistered} in a prospective, observational study. Points of measurement: T1: diagnosis of sepsis or septic shock; T2 and T3: 24 h and 48 h after the start of CytoSorb{\textregistered}; T4: 24 h after termination of CytoSorb{\textregistered}. Results: The hepatic biotransformation capacity measured by LiMAx{\textregistered} was severely impaired in up to 95 % of patients. Despite a rapid shock reversal under CytoSorb{\textregistered}, a significant improvement in LiMAx{\textregistered} values appeared from T3 to T4. This decline and recovery of liver function were not reflected by common parameters of hepatic metabolism that remained mostly within the normal range. Conclusions: Hepatic dysfunction can effectively and safely be diagnosed with LiMAx{\textregistered} in ventilated ICU patients under CytoSorb{\textregistered}. Various static liver parameters are of limited use since they do not adequately reflect hepatic dysfunction and impaired hepatic metabolism.",

author = "Janina Praxenthaler and Elke Schwier and Simon Altmann and Carmen Kirchner and Julian Bialas and Dietrich Henzler and Thomas K{\"o}hler",

note = "Funding Information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The study was partially funded (consumables) by intramural funds from the Faculty of Medicine, Ruhr-University Bochum. Funding Information: TK had received lecture fees from Cytosorbent Europe. The Department of Anesthesiology at Klinikum Herford received an unrestricted research grant from Cytosorbent Europe in 2018. The authors declare that they have no other competing interests. Funding Information: The authors would like to thank all dedicated doctors and nurses of the intensive care unit, who were involved in the clinical treatment of these challenging patients. Special thanks to Stephanie Erbe for the accurate data collection. We acknowledge support by the Open Access Publication Funds of the Ruhr-Universit{\"a}t Bochum. Publisher Copyright: {\textcopyright} 2022 by the authors.",

year = "2022",

month = oct,

doi = "10.3390/biomedicines10102340",

language = "English",

volume = "10",

journal = "Biomedicines",

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T1 - Immunomodulation by Hemoadsorption—Changes in Hepatic Biotransformation Capacity in Sepsis and Septic Shock

T2 - A Prospective Study

AU - Praxenthaler, Janina

AU - Schwier, Elke

AU - Altmann, Simon

AU - Kirchner, Carmen

AU - Bialas, Julian

AU - Henzler, Dietrich

AU - Köhler, Thomas

N1 - Funding Information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The study was partially funded (consumables) by intramural funds from the Faculty of Medicine, Ruhr-University Bochum. Funding Information: TK had received lecture fees from Cytosorbent Europe. The Department of Anesthesiology at Klinikum Herford received an unrestricted research grant from Cytosorbent Europe in 2018. The authors declare that they have no other competing interests. Funding Information: The authors would like to thank all dedicated doctors and nurses of the intensive care unit, who were involved in the clinical treatment of these challenging patients. Special thanks to Stephanie Erbe for the accurate data collection. We acknowledge support by the Open Access Publication Funds of the Ruhr-Universität Bochum. Publisher Copyright: © 2022 by the authors.

PY - 2022/10

Y1 - 2022/10

N2 - Background: Sepsis is often associated with liver dysfunction, which is an indicator of poor outcomes. Specific diagnostic tools that detect hepatic dysfunction in its early stages are scarce. So far, the immune modulatory effects of hemoadsorption with CytoSorb® on liver function are unclear. Method: We assessed the hepatic function by using the dynamic LiMAx® test and biochemical parameters in 21 patients with sepsis or septic shock receiving CytoSorb® in a prospective, observational study. Points of measurement: T1: diagnosis of sepsis or septic shock; T2 and T3: 24 h and 48 h after the start of CytoSorb®; T4: 24 h after termination of CytoSorb®. Results: The hepatic biotransformation capacity measured by LiMAx® was severely impaired in up to 95 % of patients. Despite a rapid shock reversal under CytoSorb®, a significant improvement in LiMAx® values appeared from T3 to T4. This decline and recovery of liver function were not reflected by common parameters of hepatic metabolism that remained mostly within the normal range. Conclusions: Hepatic dysfunction can effectively and safely be diagnosed with LiMAx® in ventilated ICU patients under CytoSorb®. Various static liver parameters are of limited use since they do not adequately reflect hepatic dysfunction and impaired hepatic metabolism.

AB - Background: Sepsis is often associated with liver dysfunction, which is an indicator of poor outcomes. Specific diagnostic tools that detect hepatic dysfunction in its early stages are scarce. So far, the immune modulatory effects of hemoadsorption with CytoSorb® on liver function are unclear. Method: We assessed the hepatic function by using the dynamic LiMAx® test and biochemical parameters in 21 patients with sepsis or septic shock receiving CytoSorb® in a prospective, observational study. Points of measurement: T1: diagnosis of sepsis or septic shock; T2 and T3: 24 h and 48 h after the start of CytoSorb®; T4: 24 h after termination of CytoSorb®. Results: The hepatic biotransformation capacity measured by LiMAx® was severely impaired in up to 95 % of patients. Despite a rapid shock reversal under CytoSorb®, a significant improvement in LiMAx® values appeared from T3 to T4. This decline and recovery of liver function were not reflected by common parameters of hepatic metabolism that remained mostly within the normal range. Conclusions: Hepatic dysfunction can effectively and safely be diagnosed with LiMAx® in ventilated ICU patients under CytoSorb®. Various static liver parameters are of limited use since they do not adequately reflect hepatic dysfunction and impaired hepatic metabolism.

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DO - 10.3390/biomedicines10102340

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AN - SCOPUS:85140443390

SN - 2227-9059

VL - 10

JO - Biomedicines

JF - Biomedicines

IS - 10

M1 - 2340

ER -

Immunomodulation by Hemoadsorption—Changes in Hepatic Biotransformation Capacity in Sepsis and Septic Shock: A Prospective Study

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ASJC Scopus Subject Areas

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