Hemoadsorption in the critically ill—Final results of the International CytoSorb Registry

• Published in: PloS one Vol. 17; no. 10; p. e0274315
• Main Authors: Hawchar, Fatime, Tomescu, Dana, Träger, Karl, Joskowiak, Dominik, Kogelmann, Klaus, Soukup, Jens, Friesecke, Singrun, Jacob, David, Gummert, Jan, Faltlhauser, Andreas, Aucella, Filippo, van Tellingen, Martijn, Malbrain, Manu L. N. G, Bogdanski, Ralph, Weiss, Günter, Herbrich, Andreas, Utzolino, Stefan, Nierhaus, Axel, Baumann, Andreas, Hartjes, Andreas, Henzler, Dietrich, Grigoryev, Evgeny, Fritz, Harald, Bach, Friedhelm, Schröder, Stefan, Weyland, Andreas, Gottschaldt, Udo, Menzel, Matthias, Zachariae, Olivier, Novak, Radovan, Berden, Jernej, Haake, Hendrik, Quintel, Michael, Kloesel, Stephan, Kortgen, Andreas, Stecher, Stephanie, Torti, Patricia, Nestler, Frieder, Nitsch, Markus, Olboeter, Detlef, Muck, Philip, Findeisen, Michael, Bitzinger, Diane, Kraßler, Jens, Benad, Martin, Schott, Martin, Schumacher, Ulrike, Molnar, Zsolt, Brunkhorst, Frank Martin
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 25.10.2022; Public Library of Science (PLoS)
• Subjects: Analysis; Biology and Life Sciences; Biomarkers; C-reactive protein; Care and treatment; Critically ill; Cytokines; Data collection; Development and progression; Ethics; Extracorporeal membrane oxygenation; Health aspects; Heart; Heart surgery; Hospitals; Immune response; Inflammation; Information sharing; Informed consent; Intensive care; Intensive care units; Interleukin 6; Measurement; Medicine and Health Sciences; Mortality; Patients; People and Places; Physiology; Procalcitonin; Public speaking; R&D; Research & development; Research and Analysis Methods; Schiller, Johann Christoph Friedrich von (1759-1805); Sepsis; Septic shock; Services; Surgery; Germany; Berlin Germany; Europe
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0274315

The aim of the current paper is to summarize the results of the International CytoSorb Registry. Data were collected on patients of the intensive care unit. The primary endpoint was actual in-hospital mortality compared to the mortality predicted by APACHE II score. The main secondary endpoints were SOFA scores, inflammatory biomarkers and overall evaluation of the general condition. 1434 patients were enrolled. Indications for hemoadsorption were sepsis/septic shock (N = 936); cardiac surgery perioperatively (N = 172); cardiac surgery postoperatively (N = 67) and "other" reasons (N = 259). APACHE-II-predicted mortality was 62.0±24.8%, whereas observed hospital mortality was 50.1%. Overall SOFA scores did not change but cardiovascular and pulmonary SOFA scores decreased by 0.4 [-0.5;-0.3] and -0.2 [-0.3;-0.2] points, respectively. Serum procalcitonin and C-reactive protein levels showed significant reduction: -15.4 [-19.6;-11.17] ng/mL; -17,52 [-70;44] mg/L, respectively. In the septic cohort PCT and IL-6 also showed significant reduction: -18.2 [-23.6;-12.8] ng/mL; -2.6 [-3.0;-2.2] pg/mL, respectively. Evaluation of the overall effect: minimal improvement (22%), much improvement (22%) and very much improvement (10%), no change observed (30%) and deterioration (4%). There was no significant difference in the primary outcome of mortality, but there were improvements in cardiovascular and pulmonary SOFA scores and a reduction in PCT, CRP and IL-6 levels.