Sistema de Salut de Catalunya
Institut Català de la Salut
[Mitzner S] Division for Tropical Medicine, Infectious Diseases and Nephrology, Department of Internal Medicine, University of Rostock, Rostock, Germany. [Kogelmann K] Department of Anesthesiology and Intensive Care Medicine, Klinikum Leer, Leer, Germany. [Ince C] Department of Intensive Care, Erasmus MC, University Medical Centre Rotterdam, GD Rotterdam, The Netherlands. [Molnár Z] Department of Anesthesiology and Intensive Care Medicine, Semmelweis University, Budapest, Hungary. CytoSorbents Europe GmbH, Berlin, Germany. [Ferrer R] Servei de Medicina Intensiva, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Grup de Recerca de Shock, Disfunció Orgànica i Ressuscitació (SODIR), Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. [Nierhaus A] Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Vall d'Hebron Barcelona Hospital Campus
2024-01-09T08:12:52Z
2024-01-09T08:12:52Z
2023-12
Hemoadsorption; Hyperinflammation; Septic shock
Hemoadsorción; Hiperinflamación; Shock séptico
Hemoadsorció; Hiperinflamació; Shock sèptic
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.
This work was partially funded (artwork, editing) by CytoSorbents Inc. US Monmouth Junction, NJ, USA.
Article
Published version
English
Xoc sèptic - Tractament; DISEASES::Bacterial Infections and Mycoses::Infection::Sepsis::Shock, Septic; Other subheadings::Other subheadings::/therapy; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Sorption Detoxification::Hemoperfusion; ENFERMEDADES::infecciones bacterianas y micosis::infección::sepsis::choque séptico; Otros calificadores::Otros calificadores::/terapia; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::desintoxicación por adsorción::hemoperfusión
MDPI
Journal of Clinical Medicine;12(23)
https://doi.org/10.3390/jcm12237199
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
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