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Blood Purification With CytoSorb in Critically Ill Patients: Single-Center Preliminary Experience

机译：血液净化患有危重病患者的细胞凋亡：单中心初步经验

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The CytoSorb adsorber, a blood purification therapy, is able to remove molecules in the 5-60 kDa range which comprises the majority of inflammatory mediators and some endogenous molecules. We aimed to evaluate CytoSorb therapy on clinical outcomes in critically ill patients. A retrospective case series study, from February 2016 to May 2017, was performed in 40 patients with multiple organ failure who received CytoSorb treatment. There were 28 patients with cardiogenic shock, 2 with septic shock, 9 with acute respiratory distress syndrome, and 1 with liver failure. Nineteen patients (47%) underwent extracorporeal membrane oxygenation, 11 (27%) had an intra-aortic balloon pump, 9 (22%) were implanted with Impella, 6 (15%) had a ventricular assist device, and 18 (45%) were treated with continuous veno-venous hemofiltration. After CytoSorb treatment, total bilirubin decreased from 11.6 +/- 9.2 to 6.8 +/- 5.1 mg/dL (P = 0.005), lactate from 12.1 +/- 8.7 to 2.9 +/- 2.5 mmol/L (P 0.001), CPK from 2416 (670-8615) to 281 (44-2769) U/L (P 0.001) and LDH from 1230 (860-3157) to 787 (536-1148) U/L (P 0.001). The vasoactive-inotropic score after 48 h of treatment was reduced to 10 points, P = 0.009. Thirty-day mortality was 55% and ICU mortality was 52.5% at expected ICU mortality of 80%. Our study shows that CytoSorb(TM) treatment is effective in reducing bilirubin, lactate, CPK and LDH, in critically ill patients mainly due to cardiogenic shock. There is a need for randomized controlled trials to conclude on the potential benefits blood purification with CytoSorb in critically ill patients.
机译：血液净化治疗的胞流吸附剂能够去除5-60kDa范围内的分子，其包含大多数炎症介质和一些内源分子。我们的旨在评估缩放性病患者临床结果的胞流疗法。从2016年2月到2017年5月的回顾性案例系列研究是在40例患有CytoSorb治疗的多种器官衰竭患者中进行的。有28例患有心形成休克的患者，2例具有脓肠柄，9例，急性呼吸窘迫综合征，1例肝功能衰竭。 19名患者（47％）接受体外膜氧合，11（27％）具有主动脉内球囊泵，9（22％）注入偶像，6（15％）具有心室助助器，18（45％） ）用连续的静脉静脉血液过滤处理。胞浆处理后，总胆红素从11.6 +/- 9.2-6.8 +/- 5.1mg / dl（p = 0.005）减少，乳酸盐从12.1 +/- 8.7至2.9 +/- 2.5mmol / L（P <0.001） ，从2416（670-8615）至281（44-2769）U / L（P <0.001）和LDH的CPK（860-3157）至787（536-1148）U / L（P <0.001） 。治疗48小时后的血管活性型分数降至10分，P = 0.009。 30天死亡率为55％，ICU死亡率为80％的预期ICU死亡率为52.5％。我们的研究表明，CytoSorb（TM）治疗可有效地减少胆红素，乳酸，CPK和LDH，主要是由于心形成休克。需要随机对照试验结束潜在的益处血液净化患者患者患者。

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