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K S Houschyar, I Nietzschmann, F Siemers
No abstract text is available yet for this article.
December 8, 2016: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
Karl Träger, Daniel Fritzler, Guenther Fischer, Janpeter Schröder, Christian Skrabal, Andreas Liebold, Helmut Reinelt
The use of cardiopulmonary bypass (CPB) in cardiothoracic surgery results in a well-known activation of the immunologic response. In some cases, however, this triggered immunologic response may be excessive, leading to a severe systemic inflammatory response syndrome (SIRS) and induced organ dysfunction. For example, patients frequently develop hemodynamic instability with hypotension and low systemic vascular resistance. To date, different therapeutic approaches, such as steroids, have been tried to control this maladaptive postoperative SIRS response, yet definitive proof of clinical efficacy is missing...
May 16, 2016: International Journal of Artificial Organs
Dana R Tomescu, Simona Olimpia Dima, Daniela Ungureanu, Mihai Popescu, Dan Tulbure, Irinel Popescu
INTRODUCTION: Emergency transplantation of a donor liver that is not matched for the major blood antigens can produce marked immune-mediated cytokine release that can cause donor graft loss. Control of the inflammatory response may be a key element in treatment. METHODS: We present the case of a 46-year-old man with primary graft nonfunction after liver transplantation who underwent emergency retransplantation with an ABO-incompatible graft. A severe inflammatory response syndrome (SIRS) was noted in the perioperioperative period of retransplantation...
May 16, 2016: International Journal of Artificial Organs
Martin H Bernardi, Harald Rinoesl, Klaus Dragosits, Robin Ristl, Friedrich Hoffelner, Philipp Opfermann, Christian Lamm, Falk Preißing, Dominik Wiedemann, Michael J Hiesmayr, Andreas Spittler
BACKGROUND: Cardiopulmonary bypass (CPB) surgery initiates a systemic inflammatory response, which is associated with postoperative morbidity and mortality. Hemoadsorption (HA) of cytokines may suppress inflammatory responses and improve outcomes. We tested a new sorbent used for HA (CytoSorb™; CytoSorbents Europe GmbH, Berlin, Germany) installed in the CPB circuit on changes of pro- and anti-inflammatory cytokines levels, inflammation markers, and differences in patients' perioperative course...
April 9, 2016: Critical Care: the Official Journal of the Critical Care Forum
Markus Gehling, Michael Tryba
Hemofiltration with Cytosorb can reduce cytokines in sepsis. Since cytokines are involved in the development of vasodilatatory shock in sepsis, their reduction might improve the chance of survival in this condition. In spite of the CE-approval of Cytosorb clinical efficacy has not been proved so far. Other techniques reducing cytokines by direct or indirect manners failed to prove an influence on sepsis mortality. Moreover, the nonspecific elimination of pro- and anti-inflammatory cytokines may result in different clinical effects...
March 2016: Deutsche Medizinische Wochenschrift
Andreas Baumann, Dirk Buchwald, Thorsten Annecke, Martin Hellmich, Peter K Zahn, Andreas Hohn
BACKGROUND: On-pump cardiac surgery triggers a significant postoperative systemic inflammatory response, sometimes resulting in multiple-organ dysfunction associated with poor clinical outcome. Extracorporeal cytokine elimination with a novel haemoadsorption (HA) device (CytoSorb®) promises to attenuate inflammatory response. This study primarily assesses the efficacy of intraoperative HA during cardiopulmonary bypass (CPB) to reduce the proinflammatory cytokine burden during and after on-pump cardiac surgery, and secondarily, we aim to evaluate effects on postoperative organ dysfunction and outcomes in patients at high risk...
March 12, 2016: Trials
Karl Träger, Christian Schütz, Günther Fischer, Janpeter Schröder, Christian Skrabal, Andreas Liebold, Helmut Reinelt
A 45-year-old male was admitted to our hospital with a small bowel obstruction due to torsion and was immediately scheduled for surgical intervention. At anesthesia induction, the patient aspirated and subsequently developed a severe SIRS with ARDS and multiple organ failure requiring the use of ECMO, CRRT, antibiotics, and low dose steroids. Due to a rapid deterioration in clinical status and a concurrent surge in inflammatory biomarkers, an extracorporeal cytokine adsorber (CytoSorb) was added to the CRRT blood circuit...
2016: Case Reports in Critical Care
Katharina Linden, Vittorio Scaravilli, Stefan F X Kreyer, Slava M Belenkiy, Ian J Stewart, Kevin K Chung, Leopoldo C Cancio, Andriy I Batchinsky
INTRODUCTION: Host inflammatory response to any form of tissue injury, including burn, trauma, or shock, has been well documented. After significant burns, cytokines can increase substantially within the first 24 h after injury and may contribute to subsequent organ failure. Hemoadsorption by cytokine-adsorbing columns may attenuate this maladaptive response, thereby improving outcomes. The aim of this study was to investigate the feasibility, technical safety, and efficacy of cytokine and myoglobin removal by early use of a cytokine absorbing column (CytoSorb) in a porcine model of smoke inhalation and burn injury...
November 2015: Shock
Burkhard Hinz, Oliver Jauch, Toralf Noky, Sigrun Friesecke, Peter Abel, Rolf Kaiser
INTRODUCTION: Hemoadsorption using CytoSorb has gained attention as a potential immunotherapy to control systemic inflammation and sepsis. We report on a patient with septic shock, successfully treated with CytoSorb therapy. METHODS: A 72-year-old male with periodically recurring infectious episodes was admitted with the suspicion of urosepsis. In the following hours his hemodynamic situation deteriorated markedly, exhibiting respiratory-metabolic acidosis, elevated inflammatory marker plasma levels, a severely disturbed coagulation, increased retention parameters, liver dysfunction, and confirmation of bacteria and leucocytes in urine...
August 2015: International Journal of Artificial Organs
Saroj Kumar Pattnaik, Bibekananda Panda
No abstract text is available yet for this article.
May 2015: Indian Journal of Critical Care Medicine
Frank Bruenger, Lukasz Kizner, Jan Weile, Michael Morshuis, Jan F Gummert
PURPOSE: A new hemoadsorption device intended as adjunctive treatment for patients with elevated cytokine levels in the setting of SIRS and sepsis has shown promising results. We report on the beneficial application of the device in a patient with cardiogenic septic shock receiving combined extracorporeal life support with rECMO, LVAD, and CVVH despite his highly septic condition. METHODS: A 39-year-old patient presented with fulminant ARDS and cardiogenic septic shock...
February 2015: International Journal of Artificial Organs
Marion Wiegele, Claus G Krenn
No abstract text is available yet for this article.
May 2015: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Reshma Basu, Sunjay Pathak, Jyoti Goyal, Rajeev Chaudhry, Rati B Goel, Anil Barwal
CytoSorb(®) (CytoSorbents Corporation, USA) is a novel sorbent hemoadsorption device for cytokine removal. The aim of this study was to examine the clinical use of CytoSorb(®) in the management of patient with septic shock. We used this device as an adjuvant to stabilize a young patient with multi-organ failure and severe sepsis with septic shock. A 36-year-old female patient was hospitalized with the complaints of malaise, general body ache, and breathing difficulty and had a medical history of diabetes mellitus type II, hypertension, obstructive sleep apnea, hypothyroidism and morbid obesity...
December 2014: Indian Journal of Critical Care Medicine
Hubert Hetz, Reinhard Berger, Peter Recknagel, Heinz Steltzer
INTRODUCTION: Numerous animal studies and preliminary data from a clinical trial in septic patients demonstrated that a decrease in blood cytokine levels using an extracorporeal cytokine filter (CytoSorb) can effectively attenuate the inflammatory response during sepsis and possibly improve outcomes. METHODS: A 60-year-old female was admitted to hospital due to a forearm fracture. After surgical wound care by osteosynthesis the patient developed surgical wound infection which progressed to necrotizing fasciitis...
May 2014: International Journal of Artificial Organs
Craig R Vocelka, Krystal M Jones, Krasimira M Mikhova, Ryan M Ebisu, Ashley Shar, John A Kellum, Edward D Verrier, David G Rabkin
Little is known about the effect of cardiopulmonary bypass alone on cardiac function; in an attempt to illuminate this relationship and test a possible mechanism, we used Cytosorb, a device capable of removing virtually all types of circulating cytokines to test the hypothesis that hemoadsorption of cytokines during bypass attenuates bypass-induced acute organ dysfunction. Twelve Yorkshire pigs (50-65 kg) were instrumented with a left ventricular conductance catheter. Baseline mechanics and cytokine expression (tumor necrosis factor [TNF], interleukin-6 [IL-6], and interleukin-10) were measured before and hourly after 1 hour of normothermic cardiopulmonary bypass...
December 2013: Journal of Extra-corporeal Technology
George O Angheloiu, Heribert Hänscheid, Christoph Reiners, William D Anderson, John A Kellum
BACKGROUND: Contrast-induced acute kidney injury is a severe condition resulting from the use of radiology contrast in patients with predisposing factors. HYPOTHESIS: We hypothesized that a novel system including a device containing polymer resin sorbent beads and a custom-made suctioning catheter could efficiently remove contrast from an in vitro novel model of circulatory system (MOCS) mimicking the cerebral circulation. METHODS: A custom-made catheter was built and optimized for cerebral venous approach...
July 2013: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Patrick M Honore, Rita Jacobs, Olivier Joannes-Boyau, Jouke De Regt, Elisabeth De Waele, Viola van Gorp, Willem Boer, Lies Verfaillie, Herbert D Spapen
In recent years, after all the attention has been focused on the dose for continuous renal replacement therapy (CRRT) in sepsis and systemic inflammation response syndrome (SIRS), the relatively negative results of all those studies did urge our expectations on new approaches regarding CRRT in sepsis and SIRS. So far, after the failure of the major randomized studies on dose, attention is now drawn to new membranes that could better eliminate massive amounts of unbound mediators in wider spectrum and also in greater magnitude Nevertheless, for septic acute kidney injury, the recommended dose will remain 35 ml/kg/h until the IVOIRE (hIgh VOlume in Intensive Care) study will be published...
March 2013: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Takumi Taniguchi
Sepsis induces the activation of complement and the release of inflammatory cytokines such as TNF-alpha and IL-1beta. The inflammatory cytokines and nitric oxide induced by sepsis can 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. Recently, several experimental and clinical studies have reported that treatment for adsorption of cytokines is beneficial during endotoxemia and sepsis...
2010: Contributions to Nephrology
Zhi-Yong Peng, Melinda J Carter, John A Kellum
OBJECTIVE: A broad-spectrum immune-regulating therapy could be beneficial in the treatment of sepsis. Our previous studies have shown that a hemoadsorption device (CytoSorb) removes both pro- and anti-inflammatory cytokines and improves survival in experimental endotoxemia. We sought to determine whether hemoadsorption can also be effective in the treatment of sepsis. DESIGN: Randomized controlled laboratory experiment. SETTING: University laboratory...
May 2008: Critical Care Medicine
John A Kellum, Ramesh Venkataraman, David Powner, Michele Elder, Georgene Hergenroeder, Melinda Carter
BACKGROUND: Inflammatory cytokines occur in the circulation and in the tissues after brain death and have been associated with dysfunction of donor organs before and after transplantation. OBJECTIVE: To determine the feasibility of removing cytokines using a hemoadsorption device. DESIGN: Two-center, randomized, open-label, feasibility study in which brain-dead subjects were randomized to two treatment groups. SETTING: Two U...
January 2008: Critical Care Medicine
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