Experience with hemoadsorption (CytoSorb~?) in the management of septic shock patients

作     者：Yatin Mehta Chitra Mehta Ashish Kumar Joby Varghese George Aditi Gupta Saurabh Nanda Gourav Kochhar Arun Raizada 

作者机构：Medanta The Medicity 

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

年 卷 期：2020年第9卷第1期

页      面：1-12页

学科分类：100218[医学-急诊医学] 1002[医学-临床医学] 1010[医学-医学技术（可授医学、理学学位）] 10[医学] 

主　　题：Hemoadsorption Sepsis Cytokines Clinical conditions Inflammation and extracorporeal 

摘      要：BACKGROUND Cytokines and inflammatory mediators are the hallmarks of *** cytokine hemoadsorption devices are the newer clinical support system to overcome the cytokine storm during *** To retrospectively evaluate the clinical outcomes of patients admitted in intensive care unit with septic shock with different *** The laboratory parameters including biomarkers such as procalcitonin,serum lactate and C-reactive protein;and the hemodynamic parameters;mean arterial pressure,vasopressor doses,sepsis scores,cytokine levels and other vital parameters were *** evaluated these outcomes among survivors and *** Of 100 patients evaluated,40 patients *** treatment,the vasopressors dosage remarkably decreased though it was not statistically different;34.15%(P=0.0816)for epinephrine,20.5%for norepinephrine(P=0.3099)and 51%(P=0.0678)for *** the survivor group,a remarkable reduction of biomarkers levels;procalcitonin(65%,P=0.5859),C-reactive protein(27%,P=0.659),serum lactate(27%,P=0.0159)and bilirubin(43.11%;P=0.0565)were observed from baseline after CytoSorb^® therapy.A significant reduction in inflammatory markers;interleukin 6 and interleukin 10;(87%and 92%,P0.0001)and in tumour necrosis factor(24%,P=0.0003)was also ***,28(28%)patients who were given CytoSorb^® therapy less than 48 h after onset of septic shock survived and the maximum duration of stay for 70%of these patients in intensive care unit was less than 15 *** CytoSorb^® is a safe and well tolerated rescue therapy option in patients with septic ***,early(preferably within48 h after onset of septic shock)initiation could result in better clinical *** randomized trials are needed to define the potential benefits of this new treatment modality.