Clinical effects of hemoadsorption with CytoSorb ® in patients with severe acute pancreatitis: A case series

Abstract

Hemoadsorption using CytoSorb^® has recently gained attention as a new therapy aimed at modulating the inflammatory response syndrome in critically ill patients. The aim of our study was to assess the clinical effects of CytoSorb in patients with severe acute pancreatitis. We prospectively included 12 patients admitted to the intensive care unit for severe acute pancreatitis. After inclusion, continuous venovenous hemodiafiltration in conjunction with CytoSorb was applied. Clinical data, number of organ dysfunctions, paraclinical data, and vasopressor support were collected before and after the treatment. The use of CytoSorb was associated with a decrease in C-reactive protein from 242 (30, 300) to 180 (20, 252) mg/L (p = 0.04) and procalcitonin from 2.21 (0.01, 15.02) to 1.10 (0.01, 3.79) ng/mL (p = 0.02). The median vasopressor support was 0.1 (0, 0.9) mg/h at the beginning of the treatment and it was discontinued in all cases after the treatment. In conclusion, the use of CytoSorb in patients with severe acute pancreatitis was associated with improved hemodynamics and decreased inflammatory markers.

Keywords

Sorbents artificial kidney apheresis and detoxification techniques hemodynamics organ therapy hemodiafiltration sepsis

Get full access to this article

View all access options for this article.

References

Minkov

Halacheva

Yovtchev

et al . Pathophysiological mechanisms of acute pancreatitis define inflammatory markers of clinical prognosis. Pancreas 2015; 44(5): 713–717.

Landahl

Ansari

Andersson

Severe acute pancreatitis: gut barrier failure, systemic inflammatory response, acute lung injury, and the role of the mesenteric lymph. Surg Infect 2015; 16(6): 651–656.

Parniczky

Kui

Szentesi

et al . Prospective, multicentre, nationwide clinical data from 600 cases of acute pancreatitis. PLoS ONE 2016; 11(10): e0165309.

Staubli

Oertli

Nebiker

CA.

Laboratory markers predicting severity of acute pancreatitis. Crit Rev Clin Lab Sci 2015; 52(6): 273–283.

Friesecke

Träger

Schittek

et al . International registry on the use of the CytoSorb^® adsorber in ICU patients: study protocol and preliminary results. Med Klin Intensivmed Notfmed. Epub ahead of print 4 September 2017. DOI: 10.1007/s00063-017-0342-5.

Tomescu

Olimpia Dima

Ungureanu

et al . First report of cytokine removal using CytoSorb^® in severe noninfectious inflammatory syndrome after liver transplantation. Int J Artif Organs 2016; 39(3): 136–140.

Bonavia

Groff

Karamchandani

et al . Clinical utility of extracorporeal cytokine hemoadsorption therapy: a literature review. Blood Purif 2018; 46(4): 337–349.

Tenner

Baillie

DeWitt

et al . American College of Gastroenterology guideline: management of acute pancreatitis. Am J Gastroenterol 2013; 108(9): 1400–1415.

Kogelmann

Jarczak

Scheller

et al . Hemoadsorption by CytoSorb in septic patients: a case series. Crit Care 2017; 21(1): 74.

10.

Tee

Fang

Kuo

et al . Serial evaluation of the SOFA score is reliable for predicting mortality in acute severe pancreatitis. Medicine 2018; 97(7): e9654.

11.

Vincent

Moreno

Takala

et al . The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med 1996; 22(7): 707–710.

12.

Hinz

Jauch

Noky

et al . CytoSorb, a novel therapeutic approach for patients with septic shock: a case report. Int J Artif Organs 2015; 38(8): 461–464.

13.

Dahaba

Rehak

List

WF.

Procalcitonin and C-reactive protein plasma concentrations in nonseptic uremic patients undergoing hemodialysis. Intensive Care Med 2003; 29(4): 579–583.