Multicentered prospective investigator initiated study to evaluate the clinical outcomes with extracorporeal cytokine adsorption device (CytoSorb®) in patients with sepsis and septic shock

作     者：Rajib Paul Prachee Sathe Senthil Kumar Shiva Prasad Ma Aleem Prashant Sakhalvalkar 

作者机构：Department of Internal Medicine and Critical CareApollo Health CityHyderabad 500033India Department of Critical Care MedicineRuby Hall ClinicPune 411001India Department of Critical Care MedicineApollo HospitalChennai 600006India Department of Anesthesiology and Critical CareNarayana Institute of Cardiac SciencesBangaluru 560099India 

出 版 物：《World Journal of Critical Care Medicine》 (世界重症医学杂志)

年 卷 期：2021年第10卷第1期

页      面：22-34页

学科分类：100218[医学-急诊医学] 1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 1010[医学-医学技术（可授医学、理学学位）] 100401[医学-流行病与卫生统计学] 10[医学] 

主　　题：Acute physiology and chronic health evaluation score Hemadsorption Sepsis Sequential organ failure assessment score Vasopressor 

摘      要：BACKGROUND Sepsis is a severe clinical syndrome related to the host response to *** severity of infections is due to an activation cascade that will lead to an auto amplifying cytokine production:The cytokine *** by CytoSorb®therapy is a new technology that helps to address the cytokine storm and to regain control over various inflammatory *** To evaluate prospectively CytoSorb®therapy used as an adjunctive therapy along with standard of care in septic patients admitted to intensive care unit(ICU).METHODS This was a prospective,real time,investigator initiated,observational multicenter study conducted in patients admitted to the ICU with sepsis and septic *** improvement of mean arterial pressure and reduction of vasopressor needs were evaluated as primary *** change in laboratory parameters,sepsis scores[acute physiology and chronic health evaluation(APACHE II)and sequential organ failure assessment(SOFA)]and vital parameters were considered as secondary *** outcomes were also evaluated in the survivor and nonsurvivor *** statistics were used;a P value0.05 was considered RESULTS Overall,45 patients aged≥18 and≤80 years were included;the majority were men(n=31;69.0%),with mean age 47.16±14.11 *** CytoSorb®therapy,26 patients survived and 3 patients were lost to *** the survivor group,the percentage dose reduction in vasopressor was norepinephrine(51.4%),epinephrine(69.4%)and vasopressin(13.9%).A reduction in interleukin-6 levels(52.3%)was observed in the survivor *** count improved to 30.1%(P=0.2938),and total lung capacity count significantly reduced by 33%(P0.0001).Serum creatinine and serum lactate were reduced by 33.3%(P=0.0190)and 39.4%(P=0.0120),*** mean APACHE II score was 25.46±2.91 and SOFA scores was 12.90±4.02 before initiation of CytoSorb®therapy,and they were reduced significantly post therapy(APACHE II 20.1±2.47;P0.0001 and SOFA 9.04±3.0