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https://www.readbyqxmd.com/read/28589286/extracorporeal-cytokine-elimination-as-rescue-therapy-in-refractory-septic-shock-a-prospective-single-center-study
#1
Sigrun Friesecke, Stephanie-Susanne Stecher, Stefan Gross, Stephan B Felix, Axel Nierhaus
Sepsis is the most common cause of death in medical intensive care units (ICU). If sepsis progresses to refractory septic shock, mortality may reach 90-100% despite optimum current therapy. Extracorporeal cytokine adsorption in addition to regular therapy was studied prospectively in refractory septic shock patients on a medical ICU. Refractory shock was defined as increasing vasopressor dose required to maintain mean arterial blood pressure above 65 mmHg or increasing lactate levels despite protocol-guided shock therapy for 6 h...
June 6, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28587802/cytokine-filtration-modulates-pulmonary-metabolism-and-edema-formation-during-ex-vivo-lung-perfusion
#2
Ilker Iskender, Tugba Cosgun, Stephan Arni, Michael Trinkwitz, Stefan Fehlings, Yoshito Yamada, Nikola Cesarovic, Keke Yu, Thomas Frauenfelder, Wolfgang Jungraithmayr, Walter Weder, Ilhan Inci
BACKGROUND: Ex vivo lung perfusion (EVLP) has improved the process of donor lung management. Cytokine accumulation during EVLP has been shown to correlate with worse outcome after lung transplantation. Our objective in this study was to test the safety and efficacy of cytokine filtration during EVLP in a large animal model. METHODS: Pig donor lungs were preserved for 24 hours at 4°C, followed by 12 hours of EVLP, according to the Toronto protocol. The perfusate was continuously run through an absorbent device (CytoSorb) via a veno-venous shunt from the reservoir in the filter group...
May 20, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28574114/venlafaxine-intoxication-with-development-of-takotsubo-cardiomyopathy-successful-use-of-extracorporeal-life-support-intravenous-lipid-emulsion-and-cytosorb%C3%A2
#3
Ines Schroeder, Michael Zoller, Matthias Angstwurm, Felix Kur, Lorenz Frey
We describe a young patient who ingested 18 g (240 times the daily therapeutic dose) of venlafaxine in a suicide attempt. She developed severe cardiomyopathy in a takotsubo distribution causing cardiogenic shock and multi-organ dysfunction syndrome (MODS). She was successfully treated with intravenous lipid emulsion (ILE), extracorporeal life support (ECLS) and CytoSorb®. This is remarkable as, to the best of the authors' knowledge, this is the highest amount of venlafaxine intake seen in the literature with a nonfatal outcome...
May 23, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28574104/ecmo-and-cytokine-removal-for-bridging-to-surgery-in-a-patient-with-ischemic-ventricular-septal-defect-a-case-report
#4
Stefanie Marek, Gunnar Gamper, Georg Reining, Peter Bergmann, Harald Mayr, Andreas Kliegel
Even in the modern era of percutaneous coronary intervention, postinfarction ventricular septal defect (VSD) remains a serious and often lethal complication. Whether or not immediate surgical repair or delaying surgery a few days aided by intra-aortic counterpulsation provides the optimal strategy remains a matter of debate. An interdisciplinary approach of intensivists and cardiac surgeons in this setting is mandatory. We report the use of veno-arterial extracorporeal membrane oxygenation and extracorporeal blood purification therapy (CytoSorb®) as bridging to surgical closure in a patient with an ischemic VSD leading to protracted cardiogenic shock after posterior myocardial infarction...
May 23, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28525674/continuous-hemoadsorption-with-a-cytokine-adsorber-during-sepsis-a-review-of-the-literature
#5
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 Siemers
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...
May 29, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28525670/hemoadsorption-treatment-of-patients-with-acute-infective-endocarditis-during-surgery-with-cardiopulmonary-bypass-a-case-series
#6
Karl Träger, Christian Skrabal, Guenther Fischer, Thomas Datzmann, Janpeter Schroeder, Daniel Fritzler, Jan Hartmann, Andreas Liebold, Helmut Reinelt
INTRODUCTION: Infective endocarditis is a serious disease condition. Depending on the causative microorganism and clinical symptoms, cardiac surgery and valve replacement may be needed, posing additional risks to patients who may simultaneously suffer from septic shock. The combination of surgery bacterial spreadout and artificial cardiopulmonary bypass (CPB) surfaces results in a release of key inflammatory mediators leading to an overshooting systemic hyperinflammatory state frequently associated with compromised hemodynamic and organ function...
May 29, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28370393/removal-of-focal-segmental-glomerulosclerosis-fsgs-factor-supar-using-cytosorb
#7
Heiko Schenk, Janina Müller-Deile, Roland Schmitt, Jan Hinrich Bräsen, Hermann Haller, Mario Schiffer
Treatment of primary focal segmental glomerulosclerosis (FSGS) and its recurrence after kidney transplantation associated with rapid deterioration of kidney function remains to be challenging despite advances in immunosuppressive therapy. The presence of circulating factors has been postulated to be a pivotal player in the pathogenesis of FSGS, although suPAR and CLCF-1 have been identified as the most promising causative factors. The potential therapeutic effect of suPAR elimination in an FSGS patient using CytoSorb, a hemoadsorption device that gained attention in the cytokine elimination in septic patients, was studied...
March 29, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28343448/hemoadsorption-by-cytosorb-in-septic-patients-a-case-series
#8
Klaus Kogelmann, Dominik Jarczak, Morten Scheller, Matthias Drüner
BACKGROUND: Septic shock, defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, is a highly lethal condition that causes substantial morbidity and mortality among critically ill patients. One of the hallmarks of sepsis is the excessive release of cytokines and other inflammatory mediators causing refractory hypotension, tissue damage, metabolic acidosis and ultimately multiple organ failure. In this context, cytokine reduction by hemoadsorption represents a new concept for blood purification, developed to attenuate the overwhelming systemic levels of pro-inflammatory and anti-inflammatory mediators released in the early phase of sepsis...
March 27, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28149527/high-performance-of-a-unique-mesoporous-polystyrene-based-adsorbent-for-blood-purification
#9
Jian Chen, Wenyan Han, Jie Chen, Wenhui Zong, Weichao Wang, Yue Wang, Guanghui Cheng, Chunran Li, Lailiang Ou, Yaoting Yu
A multi-functional polystyrene based adsorbent (NKU-9) with a unique mesoporous and a high surface area was prepared by suspension polymerization for removal of therapeutic toxins in blood purification. The adsorbent produced had an almost equal amount of mesopore distribution in the range from 2 to 50 nm. The adsorption of serum toxins with different molecular weights were examined by in vitro adsorption assays and compared with some clinical currently used adsorbents such as HA-330, Cytosorb and BL-300 which are produced by China, America and Japan, respectively...
February 2017: Regenerative Biomaterials
https://www.readbyqxmd.com/read/28127473/hemadsorption-with-adult-cytosorb%C3%A2-in-a-low-weight-pediatric-case
#10
Catalin Gabriel Cirstoveanu, Ileana Barascu, Samantha Mc Kenzie Stancu
Cytokine adsorber (CytoSorb) has been used successfully as adjunctive treatment for adult patients with elevated cytokine levels in the setting with severe sepsis and septic shock and to reduce blood myoglobin, unconjugated bilirubin, and conjugated bilirubin. In this article we present the case of a nine-month-old male infant who was admitted to the NICU due to sepsis after cardiac surgery, Fallot tetralogy, and multisystem organ failure (MSOF) including liver failure and renal failure which was successfully treated by a combination of continuous hemodiafiltration (HDF) and hemadsorption with CytoSorb...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28127437/effect-of-extracorporeal-cytokine-removal-on-vascular-barrier-function-in-a-septic-shock-patient
#11
Sascha David, Kristina Thamm, Bernhard M W Schmidt, Christine S Falk, Jan T Kielstein
BACKGROUND: Sepsis and septic shock are major healthcare problems, affecting millions of individuals around the world each year. Pathophysiologically, septic multiple organ dysfunction (MOD) is a life-threatening condition caused by an overwhelming systemic inflammatory response of the host's organism to an infection. We experimentally tested if high circulating cytokine levels might increase vascular permeability-a critical hallmark of the disease-and if this phenomenon can be reversed by therapeutic cytokine removal (CytoSorb®) in an exemplary patient...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/27931049/-the-use-of-a-cytokine-adsorber-cytosorb-in-a-patient-with-septic-shock-and-multi-organ-dysfunction-mods-after-a-severe-burn-injury
#12
K S Houschyar, I Nietzschmann, F Siemers
No abstract text is available yet for this article.
December 8, 2016: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/27140295/treatment-of-post-cardiopulmonary-bypass-sirs-by-hemoadsorption-a-case-series
#13
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
https://www.readbyqxmd.com/read/27079418/first-report-of-cytokine-removal-using-cytosorb%C3%A2-in-severe-noninfectious-inflammatory-syndrome-after-liver-transplantation
#14
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
https://www.readbyqxmd.com/read/27059056/effect-of-hemoadsorption-during-cardiopulmonary-bypass-surgery-a-blinded-randomized-controlled-pilot-study-using-a-novel-adsorbent
#15
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/26983116/-is-the-time-ripe-for-cytosorb
#16
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
https://www.readbyqxmd.com/read/26971164/reccas-removal-of-cytokines-during-cardiac-surgery-study-protocol-for-a-randomised-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/26885411/cytokine-reduction-in-the-setting-of-an-ards-associated-inflammatory-response-with-multiple-organ-failure
#18
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
https://www.readbyqxmd.com/read/26368927/evaluation-of-the-cytosorb%C3%A2-hemoadsorptive-column-in-a-pig-model-of-severe-smoke-and-burn-injury
#19
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
https://www.readbyqxmd.com/read/26349530/cytosorb-a-novel-therapeutic-approach-for-patients-with-septic-shock-a-case-report
#20
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
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