The COSMOS Registry of CytoSorb Hemoadsorption Therapy in Critically Ill Patients: Protocol for an International, Prospective Registry.

Publication date: Nov 05, 2024

Extracorporeal blood purification with CytoSorb has been increasingly used as an adjunctive therapy in several hyperinflammatory critical care conditions, as well as to remove elevated levels of myoglobin or bilirubin in patients with rhabdomyolysis or liver failure. Despite the increasing worldwide use of hemoadsorption, data from large international multicenter studies are still lacking. The COSMOS (CytoSorb Treatment Of Critically Ill Patients) registry is a company-sponsored registry by CytoSorbents Corporation and CytoSorbents Medical Inc. and will provide a data repository and reporting infrastructure for the surveillance of CytoSorb use in real-world critical care settings in an unselected, critically ill patient population. The gathered data will serve as a comprehensive resource to assess the effects of such therapy on patients’ management. The international COSMOS registry is collecting prospective data for patients treated with CytoSorb during routine care in various critical care indications, based on the decision of the treating physicians. Data are collected at baseline, during CytoSorb therapy, 24 hours thereafter, at discharge from the intensive care unit and the hospital, and on day 90. Key outcomes assessed include change in inflammatory biomarkers, vasopressor requirements, fluid balance, organ function and organ support, length of intensive care unit and hospital stay, occurrence of adverse events, and mortality. The COSMOS registry started with the inclusion of the first patient on July 15, 2022, and is now actively enrolling in 4 countries (Germany, Spain, Portugal, and Italy), with plans to expand to other countries outside of Europe. An initial readout is planned for presentation at an international Critical Care conference in 2024. The COSMOS registry is intended to provide comprehensive real-world data on patient outcomes with CytoSorb in various critical care indications, thereby contributing to optimization of patient selection, timing of initiation, and dosing of hemoadsorption treatment. ClinicalTrials. gov NCT05146336; https://clinicaltrials. gov/study/NCT05146336. DERR1-10. 2196/55880.

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Concepts Keywords
Germany adsorption
Hyperinflammatory Critical Illness
Physicians CytoSorb
Spain extracorporeal blood purification
hemoadsorption
hemoperfusion
hospital care
Humans
hyperinflammation
liver failure
mortality
Prospective Studies
Registries
rhabdomyolysis
sepsis
septic shock

Semantics

Type Source Name
disease MESH Critically Ill
disease IDO blood
disease MESH rhabdomyolysis
disease MESH liver failure
drug DRUGBANK Isoxaflutole
drug DRUGBANK Huperzine B
disease MESH Sepsis
disease MESH COVID 19
disease MESH Shock
disease MESH septic shock
disease MESH inflammation
disease MESH multiple organ failure
drug DRUGBANK Flunarizine
disease IDO endotoxin
disease MESH acute respiratory distress syndrome
drug DRUGBANK Ticagrelor
drug DRUGBANK Rivaroxaban
disease MESH contraindications
drug DRUGBANK Methionine
disease MESH Hemophagocytic lymphohistiocytosis
disease MESH Cardiogenic shock
disease MESH cardiac failure
disease MESH Acute liver failure
disease MESH acute on chronic liver failure
disease MESH Influenza
disease MESH Dengue
disease MESH Pancreatitis
disease MESH syndrome
disease MESH emergency
disease IDO site
disease MESH Comorbidity
disease MESH Sequential Organ Failure Assessment scores
disease MESH hepatic encephalopathy
disease MESH Chronic Liver Failure
disease MESH Acute kidney injury
disease MESH Critical illness polyneuropathy
disease MESH death
disease IDO quality

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