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

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...

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Published in:PloS one 2022-10, Vol.17 (10), p.e0274315-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: Article
Language:English
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
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Summary: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.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0274315