Sepsis and septic shock
Cytokines play a critical role in coordinating and amplifying a host immune response to infection. A dysregulated and overshooting host response to infection can lead to a hyper-inflammatory condition that contributes to the pathophysiology of sepsis and septic shock, a condition carrying high morbidity and mortality in critically ill patients.
"Sepsis is a complex systemic inflammatory response that affects the entire organism and affects tissues, organs and thus all vital functions. If sepsis is not may detected and treated in time, it will inevitably lead to septic shock, multiple organ failure, and death. One-third to one-half of all patients do not survive sepsis."
"Sepsis causes more deaths each year than breast cancer, prostate cancer and HIV / AIDS combined. Worldwide, 20-30 million cases are estimated annually. It is estimated that sepsis is responsible for the majority of deaths associated with HIV / AIDS, malaria, pneumonia, and other infections, whether acquired at home, in hospital, or after injury."
Potential Benefits observed when CytoSorb was used to remove cytokines in patients with septic shock:
Observed rapid and sustained reduction of cytokine burden and thus attenuation of excess immune response with subsequent potential effects:
- Improvement in hemodynamic stability (macro- and micro-circulation)
- Reduction of capillary leakage and improvement in fluid balance
- Reduction in vasopressors need
- Prevention of mediator-induced tissue damage
- Reduced production of new inflammatory mediators
- Reorientation of the cellular immune response to the focus
- Removal of additional harmful substances that are either toxic or whose accumulation can induce further complications, such as – bacterial enterotoxins – myoglobin in rhabdomyolysis – bile acids and bilirubin in septic cholestasis and or liver failure
Currently available data and ongoing studies can be found in the section “The Studies”.
References
(1) The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)
Mervyn Singer, MD, FRCP; Clifford S. Deutschman, MD, MS; Christopher Warren Seymour, MD, MSc; Manu Shankar-Hari, MSc, MD, FFICM; Djillali Annane, MD, PhD; Michael Bauer, MD; Rinaldo Bellomo, MD; Gordon R. Bernard, MD; Jean-Daniel Chiche, MD, PhD; Craig M. Coopersmith, MD; Richard S. Hotchkiss, MD; Mitchell M. Levy, MD; John C. Marshall, MD; Greg S. Martin, MD, MSc; Steven M. Opal, MD; Gordon D. Rubenfeld, MD, MS; Tom van der Poll, MD, PhD; Jean-Louis Vincent, MD, PhD; Derek C. Angus, MD, MPH JAMA. 2016;315(8):801-810
(2) Epidemiology of sepsis in Germany: results from a national prospective multicenter study.
Engel C, Brunkhorst FM, Bone HG, Brunkhorst R, Gerlach H, Grond S, Gruendling M, Huhle G, Jaschinski U, John S, Mayer K, Oppert M, Olthoff D, Quintel M, Ragaller M, Rossaint R, Stuber F, Weiler N, Welte T, Bogatsch H, Hartog C, Loeffler M, Reinhart K.
Intensive Care Med. 2007 Apr;33(4):606-18.
(3) Inpatient care for septicemia or sepsis: a challenge for patients and hospitals.
Hall MJ, Williams SN, DeFrances CJ, Golosinskiy A.
NCHS Data Brief. 2011 Jun;(62):1-8.
(4) Temporal trends in the epidemiology of severe postoperative sepsis after elective surgery: a large, nationwide sample.
Bateman BT, Schmidt U, Berman MF, Bittner EA
Anesthesiology. 2010 Apr;112(4):917-25.
*CytoSorb Therapy removes excessive levels of cytokines, bilirubin, myoglobin and ticagrelor and/or rivaroxaban intraoperatively during cardiopulmonary bypass.