Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Nov 26;22(23):12786.
doi: 10.3390/ijms222312786.

Therapeutic Modulation of the Host Defense by Hemoadsorption with CytoSorb®-Basics, Indications and Perspectives-A Scoping Review

Thomas Köhler  1 , Elke Schwier  1 , Janina Praxenthaler  1 , Carmen Kirchner  2 , Dietrich Henzler  1 , Claas Eickmeyer  1
Affiliations
Review

Therapeutic Modulation of the Host Defense by Hemoadsorption with CytoSorb®-Basics, Indications and Perspectives-A Scoping Review

Thomas Köhler et al. Int J Mol Sci. .

Abstract

The "normal" immune response to an insult triggers a highly regulated response determined by the interaction of various immunocompetent cells with pro- and anti-inflammatory cytokines. Under pathologic conditions, the massive elevation of cytokine levels ("cytokine storm") could not be controlled until the recent development of hemoadsorption devices that are able to extract a variety of different DAMPs, PAMPs, and metabolic products from the blood. CytoSorb® has been approved for adjunctive sepsis therapy since 2011. This review aims to summarize theoretical knowledge, in vitro results, and clinical findings to provide the clinician with pragmatic guidance for daily practice. English-language and peer-reviewed literature identified by a selective literature search in PubMed and published between January 2016 and May 2021 was included. Hemoadsorption can be used successfully as adjunct to a complex therapeutic regimen for various conditions. To the contrary, this nonspecific intervention may potentially worsen patient outcomes in complex immunological processes. CytoSorb® therapy appears to be safe and useful in various diseases (e.g., rhabdomyolysis, liver failure, or intoxications) as well as in septic shock or cytokine release syndrome, although a conclusive assessment of treatment benefit is not possible and no survival benefit has yet been demonstrated in randomized controlled trials.

Keywords: COVID-19; CytoSorb®; amount of blood purified; cytokine storm; cytokines; hemoadsorption; hemophagocytic syndrome; immune system; sepsis; septic shock.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests. TK has received lecture fees from Cytosorbent Europe. The Department of Anesthesiology, Surgical Intensive Care, Emergency and Pain Medicine, Ruhr University Bochum, Klinikum Herford, 32120 Herford, Germany has received an unrestricted research grant from Cytosorbent Europe in 2018.

Figures

Figure 1
Figure 1
Flowchart for study selection adapted from the PRISMA-ScR statement [12].
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Luhr R., Cao Y., Söderquist B., Cajander S. Trends in sepsis mortality over time in randomised sepsis trials: A systematic literature review and meta-analysis of mortality in the control arm, 2002–2016. Crit. Care. 2019;23:241. doi: 10.1186/s13054-019-2528-0. - DOI - PMC - PubMed
    1. Torio C.M., Andrews R.M. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs. Agency for Healthcare Research and Quality (US); Rockville, MD, USA: 2013. National Inpatient Hospital Costs: The Most Expensive Conditions by Payer, 2011: Statistical Brief #160. - PubMed
    1. Fleischmann C., Scherag A., Adhikari N.K., Hartog C.S., Tsaganos T., Schlattmann P., Angus D.C., Reinhart K. Global burden of sepsis: A systematic review. Crit. Care. 2015;19:P21. doi: 10.1186/cc14101. - DOI - PubMed
    1. Fleischmann C., Thomas-Rueddel D.O., Hartmann M., Hartog C.S., Welte T., Heublein S., Dennler U., Reinhart K. Hospital Incidence and Mortality Rates of Sepsis. Dtsch. Arztebl. Int. 2016;113:159–166. doi: 10.3238/arztebl.2016.0159. - DOI - PMC - PubMed
    1. SepNet Critical Care Trials Group Incidence of severe sepsis and septic shock in German intensive care units: The prospective, multicentre INSEP study. Intensive Care Med. 2016;42:1980–1989. doi: 10.1007/s00134-016-4504-3. - DOI - PubMed

LinkOut - more resources