Extracorporeal Blood Purification with CytoSorb in 359 Critically Ill Patients.

Publication date: Sep 05, 2023

Critically ill patients with inflammatory dysregulation and organ disfunction may benefit from blood purification, although the use of this technique has not been described in large case series. We evaluated clinical outcomes and survival in high-risk intensive care unit (ICU) patients who underwent extracorporeal blood purification. 359 consecutive ICU patients treated with CytoSorb were included. Main admission diagnoses were 120 (34%) refractory cardiac arrest under mechanical chest compression; 101 (28%) profound cardiogenic shock; 81 (23%) post-cardiotomy cardiogenic shock; and 37 (10%) respiratory failure. Fifteen patients (4%) were positive for SARS-CoV-2 infection. We observed 49% 30-day mortality, 57% ICU mortality, and 62% hospital mortality, all lower than the 71% mortality predicted by SAPS II and 68% predicted by SOFA score. Parameters of shock and organ failure, above all vasoactive inotropic score, reduced during CytoSorb treatment. Multivariable analysis identified SAPS II, lactate dehydrogenase, ICU stay duration, vasoactive inotropic score, lactates, intra-aortic counterpulsation on top of VA-ECMO, and total bilirubin as predictors of mortality. No CytoSorb-related complications occurred. CytoSorb treatment was effective in reducing laboratory parameters of shock and vasoactive inotropic score with possible survival implications in a large population of critically ill patients.

Concepts Keywords
Cardiotomy Artificial organ
Dehydrogenase Cytokines
Inflammatory Extracorporeal membrane oxygenation
Organ Hemoperfusion
Inflammatory mediators
Mechanical circulatory support


Type Source Name
disease IDO blood
disease MESH Critically Ill
disease VO organ
disease MESH cardiac arrest
disease MESH cardiogenic shock
disease MESH respiratory failure
disease MESH SARS-CoV-2 infection
pathway REACTOME SARS-CoV-2 Infection
disease MESH shock
disease MESH complications
disease VO effective
disease VO population
disease MESH Inflammation

Original Article

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