Early report: The use of Cytosorb™ haemabsorption column as an adjunct in managing severe sepsis: initial experiences, review and recommendations

Abstract

A novel synthetic haemabsorption column (Cytosorb™) has recently become commercially available. We describe its use in patients with overwhelming sepsis and consider the experience and evidence supporting its use. While Cytosorb haemabsorption is mechanistically distinct from other extracorporeal therapies in sepsis and appears effective in reducing inflammatory cytokines during sepsis, much of the basic science and clinical benefits remain unclear. Significant interactions including removal of antibiotics may be harmful and require further study. Suggestions for future research and how Cytosorb™ could be incorporated into practice are provided.

Keywords: Sepsis; cytokine; extracorporeal; haemabsorption.

Figures

Figure 1.

The Cytosorb column in use.

Figure 2.

The Cytosorb column incorporated into the return limb of a Prismaflex ST150 CVVHDF circuit.

Figure 3.

Macroscopic appearance of Cytosorb beads and electron microscopy of heavily pore covered structure.