The effect of a novel extracorporeal cytokine hemoadsorption device on IL-6 elimination in septic patients: A randomized controlled trial

Abstract:

OBJECTIVE We report on the effect of hemoadsorption therapy to reduce cytokines in septic patients with respiratory failure. METHODS This was a randomized, controlled, open-label, multicenter trial. Mechanically ventilated patients with severe sepsis or septic shock and acute lung injury or acute respiratory distress syndrome were eligible for study inclusion. Patients were randomly assigned to either therapy with CytoSorb hemoperfusion for 6 hours per day for up to 7 consecutive days (treatment), or no hemoperfusion (control). Primary outcome was change in normalized IL-6-serum concentrations during study day 1 and 7. RESULTS 97 of the 100 randomized patients were analyzed. We were not able to detect differences in systemic plasma IL-6 levels between the two groups (n = 75; p = 0.15). Significant IL-6 elimination, averaging between 5 and 18% per blood pass throughout the entire treatment period was recorded. In the unadjusted analysis, 60-day-mortality was significantly higher in the treatment group (44.7%) compared to the control group (26.0%; p = 0.039). The proportion of patients receiving renal replacement therapy at the time of enrollment was higher in the treatment group (31.9%) when compared to the control group (16.3%). After adjustment for patient morbidity and baseline imbalances, no association of hemoperfusion with mortality was found (p = 0.19). CONCLUSIONS In this patient population with predominantly septic shock and multiple organ failure, hemoadsorption removed IL-6 but this did not lead to lower plasma IL-6-levels. We did not detect statistically significant differences in the secondary outcomes multiple organ dysfunction score, ventilation time and time course of oxygenation.

DOI: 10.1371/journal.pone.0187015

Projects: SepNet - German Competence Network Sepsis

Publication type: Journal article

Journal: PloS one

Human Diseases: Disease by infectious agent

Citation: PLoS ONE 12(10):e0187015

Date Published: 30th Oct 2017

Registered Mode: imported from a bibtex file

Authors: Dirk Schädler, Christine Pausch, Daniel Heise, Andreas Meier-Hellmann, Jörg Brederlau, Norbert Weiler, Gernot Marx, Christian Putensen, Claudia Spies, Achim Jörres, Michael Quintel, Christoph Engel, John A. Kellum, Martin K. Kuhlmann

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Schädler, D., Pausch, C., Heise, D., Meier-Hellmann, A., Brederlau, J., Weiler, N., Marx, G., Putensen, C., Spies, C., Jörres, A., Quintel, M., Engel, C., Kellum, J. A., & Kuhlmann, M. K. (2017). The effect of a novel extracorporeal cytokine hemoadsorption device on IL-6 elimination in septic patients: A randomized controlled trial. In K. Eller (Ed.), PLOS ONE (Vol. 12, Issue 10, p. e0187015). Public Library of Science (PLoS). https://doi.org/10.1371/journal.pone.0187015
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Created: 15th Jul 2020 at 14:33

Last updated: 7th Dec 2021 at 17:58

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