CytoSorb

The Therapy

The CytoSorb therapy is based on an extracorporeal blood purification procedure that can effectively reduce excessive levels of inflammatory mediators (see “The Adsorber”). This is intended to alleviate the excess systemic inflammatory response (“cytokine storm”) associated with systemic hyperinflammation or septic shock. Thus, the life-threatening complications of a cytokine storm can be avoided and, above all, the stabilization of hemodynamics promoted. (Background information).

The CytoSorb therapy is an adjunctive therapy. The principles of causal and supportive therapy, such as dealing with the focal source and early anti-infective therapy, of course, retain their outstanding importance even under CytoSorb therapy. While these are primarily intended to treat the infection, CytoSorb was developed to modulate the excess immune response and thereby contribute to circulatory stabilization and increase the chance of recovery.

Safety: CytoSorb therapy has been used more than 110,000 times worldwide in more than 800 clinical departments, and its application has been proven to be well-tolerated and safe. The CytoSorb adsorber can be used for up to 24 hours after which a change is necessary if the treatment indication persists. Patients have been treated for up to seven consecutive days, for 24 hour periods.

Easy to use: The adsorber is a standard whole blood cartridge and can be used with conventional dialysis and hemofiltration equipment, as well as heart-lung machines, extracorporeal life support machines, or as a stand-alone therapy with blood pumps in hemoperfusion mode. The treatment can be prepared after a short training and can be easily integrated into routine procedures.

Treatment goals: The use of CytoSorb therapy has the following primary goals:

• Improvement of hemodynamics with significant reduction in catecholamine requirements
• Reduction in capillary leak syndrome with reversal of the fluid balance
• Reduce the excess plasma levels of a variety of inflammatory mediators (including pathogen associated molecular patterns PAMPS and damage associated molecular patterns DAMPs)
• Treatment or mitigation of secondary organ failure

For further information see under Therapeutic Effects

Previous fields of applications of CytoSorb therapy include in the intensive care unit and during surgery:

Intensive Care:

• Septic and vasoplegic shock
• Toxic shock syndrome, necrotizing fasciitis
• Hemophagocytic Lymphohistiocytosis (HLH)
• Acute Respiratory Distress Syndrome (ARDS)
• Systemic hyperinflammation after cardiac surgery with cardiopulmonary bypass (CPB)
• Cardiogenic shock
• Resuscitation or ECPR
• Polytrauma with high myoglobinemia
• Severe pancreatitis
• Liver failure of various origins (e.g., alcoholic hepatitis, acute liver failure, secondary liver failure)
• Severe burns
• Severe influenza and flu, particular requiring ECMO
• Others

Intraoperative applications in cardiac and thoracic surgery:

• Patients with long, complex procedures aortic dissections, heart transplant, complex combination interventions, re-operations
• Patients with pre-existing activation of the immune system, i.e. endocarditis, shock
• Patients with increased comorbidity including chronic impaired liver and / or kidney function

From <https://cytosorb-therapy.com/en/the-therapy/>