Real-World Outcomes of Hemoadsorption with CytoSorb® in Patients with Septic Shock: Insights from a Single-Center Study.

Abstract

BackgroundHemoadsorption is currently employed to treat septic shock and other clinical conditions involving massive inflammatory mediator release. CytoSorb^®, a device utilizing synthetic resin microbeads, provides a large adsorption surface for blood purification. This study aimed to review the clinical course of patients with septic shock treated with CytoSorb^® in our hospital's intensive care unit (ICU).Patients and MethodsThis study retrospectively analyzed the clinical course of patients with septic shock treated with CytoSorb^®, focusing on treatment timing and the volume of blood processed.ResultsBetween July 1, 2016, and December 31, 2023, 175 patients (106 men, 69 women; median age: 67 years, interquartile [IQR]: 58-85) received CytoSorb^® therapy. Survivors exhibited a significantly lower simplified acute physiology score at admission than nonsurvivors. CytoSorb^® was initiated within 24 h of shock onset in 102 patients (58%, early starters) and between 25 and 48 h in 73 patients (42%, late starters). Hemodynamic improvements elevated mean arterial pressure and reduced lactate, procalcitonin, C-reactive protein, sequential organ failure assessment scores, and noradrenaline doses in survivors. These effects were more pronounced in early starters receiving intensive treatment, who also demonstrated significantly lower lactate levels and higher mean arterial pressure at the end of therapy. Overall, 86 patients (49%) died in the ICU. Survivors underwent longer treatment durations and processed greater blood volumes than nonsurvivors.ConclusionsIn patients with septic shock treated with CytoSorb^® within 48 h of onset, treatment intensity-rather than timing-was associated with lower ICU mortality rates.