Continuous hemoadsorption with a cytokine adsorber during sepsis – a review of the literature
Int J Artif Organs 2017; 40(5): 205 - 211
Article Type: REVIEW
DOI:10.5301/ijao.5000591
Authors
Khosrow S. Houschyar, Malcolm N. Pyles, Susanne Rein, Ina Nietzschmann, Dominik Duscher, Zeshaan N. Maan, Kristian Weissenberg, Hubertus M. Philipps, Catharina Strauss, Beate Reichelt, Frank SiemersAbstract
Sepsis is a well-recognized healthcare issue worldwide, ultimately resulting in significant mortality, morbidity and resource utilization during and after critical illness. In its most severe form, sepsis causes multi-organ dysfunction that produces a state of critical illness characterized by severe immune dysfunction and catabolism. Sepsis induces the activation of complement factor via 3 pathways and the release of inflammatory cytokines such as tumor necrosis factor alpha (TNF-α) and interleukin-1beta (IL-1β), resulting in a systemic inflammatory response. The inflammatory cytokines and nitric oxide release induced by sepsis decrease systemic vascular resistance, resulting in profound hypotension. The combination of hypotension and microvascular occlusion results in tissue ischemia and ultimately leads to multiple organ failure. Several clinical and experimental studies have reported that treatment using adsorption of cytokines is beneficial during endotoxemia and sepsis. This review article analyzes the efficacy of CytoSorb® adsorber in reducing the inflammatory response during sepsis. The CytoSorb® adsorber is known to have excellent adsorption rates for inflammatory cytokines such as IL-1β, IL-6, IL-8, IL-10, and TNF-α. Studies have demonstrated that treatment with cytokine adsorbing columns has beneficial effects on the survival rate and inflammatory responses in animal septic models. Additionally, several cases have been reported in which treatment with cytokine adsorbing columns is very effective in hemodynamic stabilization and in preventing organ failure in critically ill patients. Although further investigations and clinical trials are needed, treatment with cytokine adsorbing columns may play an important role in the treatment of sepsis in the near future.
Article History
- • Accepted on 25/03/2017
- • Available online on 19/05/2017
- • Published in print on 29/05/2017
Disclosures
This article is available as full text PDF.
Authors
- Houschyar, Khosrow S. [PubMed] [Google Scholar] 1, * Corresponding Author (Khosrow.Houschyar@Bergmannstrost.com)
- Pyles, Malcolm N. [PubMed] [Google Scholar] 2
- Rein, Susanne [PubMed] [Google Scholar] 1
- Nietzschmann, Ina [PubMed] [Google Scholar] 1
- Duscher, Dominik [PubMed] [Google Scholar] 3, 4
- Maan, Zeshaan N. [PubMed] [Google Scholar] 2
- Weissenberg, Kristian [PubMed] [Google Scholar] 1
- Philipps, Hubertus M. [PubMed] [Google Scholar] 1
- Strauss, Catharina [PubMed] [Google Scholar] 5
- Reichelt, Beate [PubMed] [Google Scholar] 1
- Siemers, Frank [PubMed] [Google Scholar] 1
Affiliations
-
Department of Plastic and Hand Surgery, Burn Unit, Trauma Center Bergmannstrost Halle, Halle - Germany -
Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford School of Medicine, Stanford, CA - USA -
Section of Plastic, Aesthetic and Reconstructive Surgery, Johannes Kepler University, Linz - Austria -
Department of Plastic Surgery and Hand Surgery, Technical University Munich, Munich - Germany -
Department of Plastic and Hand Surgery, Caritas Hospital St. Josef, Regensburg - Germany
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