Prospective Study for the Application of Cytosorb® in Critically Ill Patients

Conditions

Acute Liver Injury, Cytokine Storm, Rhabdomyolysis

Keywords

Cytosorb, adsorption kinetics, saturation, critically ill patients

Brief summary

The mortality of critically ill patients is persistently high and requires targeted therapy of pathophysiological disorders. One approach to optimize therapy is the use of the cytokine adsorber Cytosorb®, which has a CE certification for the indications hyperinflammation, rhabdomyolysis and liver failure and is therefore frequently used in patients with sepsis, polytrauma and acute liver failure. Although few clinical data describe the efficiency mostly retrospectively, there are no data on real-time elimination performance and saturation kinetics during the course of treatment. These questions should be answered by the present study.

Gräfe C, Graf H, Wustrow V, Liebchen U, Conter P, Paal M, Habler K, Scharf C.

2024-09-182 citations

10.1038/s41598-024-72676-6

Extracorporeal Elimination of Pro- and Anti-inflammatory Modulators by the Cytokine Adsorber CytoSorb® in Patients with Hyperinflammation: A Prospective Study

Helen Graf, Caroline Gräfe, Mathias Bruegel, Felix L. Happich, Vassilissa Wustrow et al. (11 authors)

Infectious Diseases and Therapy2024-08-188 citations

10.1007/s40121-024-01028-8

Myoglobin adsorption and saturation kinetics of the cytokine adsorber Cytosorb® in patients with severe rhabdomyolysis: a prospective trial.

Graf H, Gräfe C, Bruegel M, Zoller M, Maciuga N, Frank S, Weidhase L, Paal M, Scharf C.

2024-06-2212 citations

10.1186/s13613-024-01334-x

Extracorporeal adsorption of protective and toxic bile acids and bilirubin in patients with cholestatic liver dysfunction: a prospective study.

Greimel A, Habler K, Gräfe C, Maciuga N, Brozat CI, Vogeser M, Zoller M, Happich FL, Liebchen U, Frank S, Paal M, Scharf C.

2023-11-0916 citations

10.1186/s13613-023-01198-7

Interventions

DEVICECytosorb therapy

Start of Cytosorb therapy is at the discretion of the attending physician

Study design

Allocation

NA

Intervention model

SINGLE_GROUP

Primary purpose

TREATMENT

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

No

Inclusion criteria

* intensive care therapy * hyperinflammation or acute liver dysfunction or rhabdomyolysis * need of continuous renal replacement therapy * treatment with Cytosorb (decision of the attending physician)

Exclusion criteria

\- other reasons for Cytosorb application

Design outcomes

Primary

Measure	Time frame	Description
Change (percentage) in different cytokines (measured as a cytokine panel) measured pre- and post-CytoSorb® (extracorporeal) in intensive care patients with hyperinflammation	12 hours	Measurement of a cytokine panel (20 different cytokines in one panel) before and after the filter at different times.
Change (percentage) in myoglobin measured pre- and post-CytoSorb® (extracorporeal) in intensive care patients with rhabdomyolysis	12 hours	Measurement of myoglobin before and after the filter at different times.
Change (percentage) in bile acids (measured as a panel) measured pre- and post-CytoSorb® (extracorporeal) in intensive care patients with acute liver failure	12 hours	Measurement of bile acids before and after the filter at different times.

Secondary

Measure	Time frame	Description
Change (percentage) in norepinephrine demand before and after the use of CytoSorb®	2 years	—
Difference (percentage) between predicted mortality and real mortality of patients treated with CytoSorb®	2 years	Mortality can be predicted by intensive care scores. We will investigate the difference between actual and predicted mortality.
Change ( percentage ) of liver toxic substances (e.g. bile acids) in patients´ blood due to the use of CytoSorb®	2 years	—
Change ( percentage ) of myoglobin in patients´ blood due to the use of CytoSorb®	2 years	—

Countries

Germany

Outcome results

None listed