Sepsis

Extracorporeal Cytokine Elimination as Rescue Therapy in Refractory Septic Shock – a Prospective Single-Center Study

Friesecke S, Stecher SS, Gross S, Felix SB, Nierhaus A
Journal Artif Organs 2017; pub

Mortality from refractory septic shock may reach 90-100% despite optimum therapy. In this study extracorporeal...

Mortality from refractory septic shock may reach 90-100% despite optimum therapy. In this study extracorporeal cytokine adsorption using CytoSorb in addition to regular therapy was studied prospectively in 20 patients with refractory shock (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 six hours). CytoSorb® treatment was started after 7.8 ± 3.7 hours of shock therapy. Following the initiation of adsorption therapy, noradrenaline dose could be significantly reduced after 6 (p=0.03) and 12 hours (p=0.001). Lactate clearance improved significantly. Shock reversal was achieved in 13 (65%) patients; 28-day survival was 45% (predicted mortality from the SOFA score was >80%). The use of CytoSorb adsorption therapy resulted in shock reversal in two thirds of these particularly difficult to treat patients.