Questions & Answers

What is CytoSorb?

CytoSorb is the first CE approved hemoadsorber for the removal of a broad spectrum of excessive elevated cytokines from blood. For this purpose the CytoSorb-Adsorber can be integrated quickly and...

CytoSorb is the first CE approved hemoadsorber for the removal of a broad spectrum of excessive elevated cytokines from blood. For this purpose the CytoSorb-Adsorber can be integrated quickly and easily into an extracorporeal circulation.

  • Next to cytokines other inflammatory mediators such as chemokines can be adsorbed.
  • Other substances, such as free hemoglobin, myoglobin, bilirubin and bile acids, bioactive lipids, light chains of antibodies, toxins, bacterial enterotoxins (Shigatoxin, alpha- hemolysin, gas gangrene-toxin, diphtheria-toxin) and other toxic metabolites can also be removed by the CytoSorb adsorber.

Does CytoSorb remove pro- and anti- inflammatory cytokines?

Yes. Generally, CytoSorb can remove hydrophobic substances with an average molecular weight in the range up to 55 kD. Substances with high concentrations are removed more efficiently than those with lower...

Yes. Generally, CytoSorb can remove hydrophobic substances with an average molecular weight in the range up to 55 kD. Substances with high concentrations are removed more efficiently than those with lower concentrations. This auto regulation protects against uncontrolled removal of endogenous substances.

  • The range of removable substances includes both, pro- and anti-inflammatory mediators with excessive plasma levels. Physiologically important constituents of plasma like albumin are not removed in clinically relevant amounts (less than 5%).
  • The aim of the CytoSorb-Therapy is to attenuate an excessive immune reaction. Inflammatory mediators are reduced, and thereby a modulating effect of the immune-system is established.
  • As described in literature, high concentrations of pro- and anti-inflammatory cytokines are associated with a high mortality.

What are the mechanisms of action in the prevention / treatment of organ failure

The key to prevention and treatment of secondary organ failure is to prevent or minimize the effect of the cytokine storm on primarily unaffected tissues (remote organs). Based on the current...

The key to prevention and treatment of secondary organ failure is to prevent or minimize the effect of the cytokine storm on primarily unaffected tissues (remote organs).

Based on the current knowledge one can assume that:

  • A reduction of cytokines and mediators in plasma through elimination and decreased de novo production occurs.
  • Hemodynamics (macro- and microcirculation) is improved and thereby the need for catecholamines is reduced.
  • A positive effect on the capillary leak syndrome by reduction of cytokine levels (integrity of the glycocalyx) can be achieved.
  • The root cause for secondary tissue damage and resulting inflammation-based (multiple) organ dysfunction is attenuated by lower levels of cytokines and inflammatory mediators. Thereby the very high morbidity and mortality may possibly be influenced positively.
  • The immune response is remodulated and the immune cells are redirected to the inflammatory focus: By applying CytoSorb the chemokine gradient, which is responsible for the migration of leukocytes to the focus (infection or tissue damage), is restored. Thereby the inflammatory focus can be demasked and the previously systemic immune response get more strongly targeted to the local focus.

Does CytoSorb remove endotoxins? Is the technology comparable with endotoxin adsorbers?

No. CytoSorb doesn't remove endotoxins which only occur in gram- negative bacterial sepsis.

  • In contrast to endotoxin-adsorption- devices, CytoSorb can also be used during gram-positive bacterial sepsis and other...

No. CytoSorb doesn’t remove endotoxins which only occur in gram- negative bacterial sepsis.

  • In contrast to endotoxin-adsorption- devices, CytoSorb can also be used during gram-positive bacterial sepsis and other systemic infections (viruses, fungi, parasites)
  • As well as cytokines, enterotoxins, such as diphtheria-toxin, alpha- hemolysin, Clostidium perfringens toxin or Shigatoxin can also be removed effectively from the circulation by CytoSorb.
  • Moreover CytoSorb can be used for all non-infectious causes of a Systemic Hyper Inflammatory Syndrome (e.g. polytrauma, burns, inhalation trauma, pancreatitis).

Is CytoSorb comparable to a dialyzer?

No. CytoSorb is an adsorber technology, which selectively binds substances physico-chemically (hydrophobic molecules with a molecular weight of up to approx. 55kD). Adsorber:

  • CytoSorb is a "blood in -...

No. CytoSorb is an adsorber technology, which selectively binds substances physico-chemically (hydrophobic molecules with a molecular weight of up to approx. 55kD).

Adsorber:

  • CytoSorb is a “blood in – blood out” device (whole blood adsorber). There is no secondary circuit with albumin, no dialysate, no ultrafiltrate.
  • Hydrophobic substances with a molecular weight of up to approx. 55KD are adsorbed within the porous structure of the polymer-beads.

Dialyzer:

  • Dialyzers use the principles of diffusion and convection.
  • Blood-components interact with a dialysate solution through a semipermeable membrane.
  • Only water soluble and very small substances (up to 10 kD) are selectively removed from the blood.
  • High Cut Off Membranes have higher thresholds for the elimination of substances. In addition to the desired substances other useful molecules such as albumin will also be eliminated

Where is CytoSorb approved for treatment?

The CytoSorb therapy is the only CE approved treatment for the removal of cytokines. It can be used in any country where CE approval is necessary or a prerequisite for...

The CytoSorb therapy is the only CE approved treatment for the removal of cytokines. It can be used in any country where CE approval is necessary or a prerequisite for registration.

What are the storage conditions for the adsorber?

As far as possible store the CytoSorb adsorber at an ambient temperature of 1-40° C (34°F- 104°F). As far as possible the CytoSorb adsorber should be stored in an upright...

As far as possible store the CytoSorb adsorber at an ambient temperature of 1-40° C (34°F- 104°F). As far as possible the CytoSorb adsorber should be stored in an upright position.