Hemoadsorption in the critically ill-Final results of the International CytoSorb Registry

被引：20

作者：

Hawchar, Fatime ^{[1
]}

Tomescu, Dana ^{[2
,3
]}

Traeger, Karl ^{[4
]}

Joskowiak, Dominik ^{[5
]}

Kogelmann., Klaus ^{[6
]}

Soukup., Jens ^{[7
]}

Friesecke, Singrun. ^{[8
]}

Jacob, David ^{[9
]}

Gummert, Jan ^{[10
]}

Faltlhauser, Andreas ^{[11
]}

Aucella, Filippo ^{[12
]}

van Tellingen, Martijn ^{[13
]}

Malbrain, Manu L. N. G. ^{[14
,15
,16
]}

Bogdanski, Ralph ^{[17
]}

Weiss, Guenter ^{[18
]}

Herbrich, Andreas ^{[19
]}

Utzolino, Stefan ^{[20
]}

Nierhaus, Axel ^{[21
]}

Baumann, Andreas ^{[22
]}

Hartjes, Andreas ^{[23
]}

Henzler, Dietrich ^{[24
]}

Grigoryev, Evgeny ^{[25
]}

Fritz, Harald ^{[26
]}

Bach, Friedhelm ^{[27
]}

Schroeder, Stefan ^{[28
]}

Weyland, Andreas ^{[29
]}

Gottschaldt, Udo ^{[30
]}

Menzel, Matthias ^{[31
]}

Zachariae, Olivier ^{[31
]}

Novak, Radovan ^{[32
]}

Berden, Jernej ^{[33
]}

Haake, Hendrik ^{[34
]}

Quintel, Michael ^{[35
]}

Kloesel, Stephan ^{[36
]}

Kortgen, Andreas ^{[37
]}

Stecher, Stephanie ^{[38
]}

Torti, Patricia ^{[39
]}

Nestler, Frieder ^{[40
]}

Nitsch, Markus ^{[41
]}

Olboeter, Detlef ^{[42
]}

Muck, Philip ^{[43
]}

Findeisen, Michael ^{[44
]}

Bitzinger, Diane ^{[45
]}

Krassler, Jens ^{[46
]}

Benad, Martin ^{[47
]}

Schott, Martin ^{[48
]}

Schumacher, Ulrike ^{[49
]}

Molnar, Zsolt ^{[50
,51
,52
,53
]}

Brunkhorst, Frank Martin ^{[54
,55
]}

机构：

[1] Univ Szeged, Dept Anesthesiol & Intens Care, Szeged, Hungary

[2] Fundeni Clin Inst, Dept Anaesthesia & Crit Care, Bucharest, Romania

[3] Carol Davila Univ Med & Pharm Bucharest, Bucharest, Romania

[4] Univ Klinikum Ulm, Kardioanasthesiol, Ulm, Germany

[5] LMU Munchen, Herzchirurg Klin & Poliklin, Univ Klinikum, Munich, Germany

[6] Hans Susemihl Krankenhaus GmbH, Klin Anasthesiol & Intens Med, Emden, Germany

[7] Carl Thiem Klinikum Cottbus, Klin Anasthesiol Intens Therapie & Palliat Med, Cottbus, Germany

[8] Univ Med Greifswald, Klin & Poliklin Innere Med B, Greifswald, Germany

[9] Univ Klinikum Magdeburg, Univ Klin Allgemein Viszeral & Gefasschirurg, Magdeburg, Germany

[10] Klin Studien Chirurg, Herz & Diabeteszentrum NRW, Bad Oeynhausen, Germany

[11] Kliniken Nordoberpfalz AG, Klinikum Weiden, Weiden, Germany

[12] Res Hosp Casa Sollievo della Sofferenza Med Sci, Nephrol & Dialysis Unit, San Giovanni, Rotondo, Italy

[13] Ziekenhuis Tjongerschans, Heerenveen, Netherlands

[14] Med Univ Lublin, Dept Anaesthesiol & Intens Therapy 1, Lublin, Poland

[15] Med Data Management, Geel, Belgium

[16] Int Fluid Acad, Lovenjoel, Belgium

[17] Tech Univ Munich, Anasthesiol Klin, AG Hamodynam, Klinikumrechts, Munich, Germany

[18] Wiener Krankenanstaltenverbund, Krankenhaus Hietzing, Vienna A, Austria

[19] Klinikum Reg Hannover Nordstadt, Klin Anasthesiol Intens Med & Schmerztherapie, Hannover, Germany

[20] Univ Klinikum Freiburg, Abt Allgemein & Viszeralchirurg, Freiburg, Germany

[21] Univ Klinikum Hamburg Eppendorf, Klin Intens Med, Hamburg, Germany

[22] Berufsgenossensch Uniklin Bergmannsheil, Klin Anasthesie Intens Palliat & Schmerzmed, Bochum, Germany

[23] Krankenhaus BHS Ried Innkreis, Ried, Austria

[24] Klinikum Herford, UK Anasthesie, Intens Med, Rettungsmed,Schmerztherapie, Herford, Germany

[25] Inst Complex Issues Cardiovasc Dis, Kemerovo, Russia

[26] Krankenhaus Martha Maria Halle Klin Anaesthesiol, Halle, Germany

[27] Evangel Krankenhaus Bielefeld, Klin Anasthesiol Intens Notfallmed Transfus Med &, Bielefeld, Germany

[28] Krankenhaus Duren Gem GmbH, Klin Anasthesiol Intens Med Notfallmed & Schmerzt, Duren, Germany

[29] Carl von Ossietzky Univ Oldenburg, Klinikum Oldenburg GmbH, Univ Klin Anasthesiol Intens Notfallmed Schmerzth, Oldenburg, Germany

[30] Heinrich Braun Klinikum Zwickau, Zwickau, Germany

[31] Klinikum Wolfsburg, Klin Anasthesie & Intens Med, Wolfsburg, Germany

[32] Klinikum Oberlausitzer Bergland GmbH, Zittau, Germany

[33] Univ Med Ctr Ljubljana, Dep Internal Med, ICU, Ljubljana, Slovenia

[34] Kliniken Maria Hilf GmbH, Klin Kardiol & Intens Med, Monchengladbach, Germany

[35] Univ Klinikum Gottingen, Zentrum Anasthesiol Rettungs & Intens Med, Gottingen, Germany

[36] GPR Klinikum Russelsheim, Abt Anasthesie, Russelsheim, Germany

[37] Univ Klinikum Jena, Klin Anasthesiol & Intens Med, Jena, Germany

[38] Klinikum Univ Munchen, Med Klin & Poliklin 2, Munich, Germany

[39] Rianimazione Osped U Parini, SC Anestesia & Rianimaz, Aosta, Italy

[40] Kliniken Erlabrunn gGmbH, Erlabrunn, Germany

[41] Krankenhaus St Elisabeth & St Barbara, Klin Anasthesie Intens Notfallmed & Schmerztherap, Halle, Germany

[42] Elbe Elster Klinikum GmbH, Krankenhaus Herzberg, Herzberg, Germany

[43] Univ Klinikum Schleswig Holstein, Lubeck, Germany

[44] Stadt Klinikum Munchen GmbH, Klinikum Harlaching, Klin Pneumol Gastroenterol Internist Intens & Bea, Munich, Germany

[45] Univ Klinikum Regensburg, Anasthesiol Klin, Regensburg, Germany

[46] Fachkrankenhaus Coswig, Klin Anasthesiol & Intens Med, Coswig, Germany

[47] Bodden Kliniken Ribnitz Damgarten, Ribnitz Damgarten, Germany

[48] Diakovere Friederikenstift, Hannover, Germany

[49] Jena Univ Hosp, Ctr Clin Studies Jena ZKS, Jena, Germany

[50] Univ Szeged, Doctoral Sch Multidisciplinary Med Sci, Szeged, Hungary

来源：

PLOS ONE | 2022年 / 17卷 / 10期

关键词：

SEPTIC SHOCK; CARDIOPULMONARY BYPASS; SEPSIS; DEFINITIONS; SURGERY;

D O I：

10.1371/journal.pone.0274315

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

The aim of the current paper is to summarize the results of the International CytoSorb Registry. Data were collected on patients of the intensive care unit. The primary endpoint was actual in-hospital mortality compared to the mortality predicted by APACHE II score. The main secondary endpoints were SOFA scores, inflammatory biomarkers and overall evaluation of the general condition. 1434 patients were enrolled. Indications for hemoadsorption were sepsis/septic shock (N = 936); cardiac surgery perioperatively (N = 172); cardiac surgery postoperatively (N = 67) and "other" reasons (N = 259). APACHE-II-predicted mortality was 62.0 +/- 24.8%, whereas observed hospital mortality was 50.1%. Overall SOFA scores did not change but cardiovascular and pulmonary SOFA scores decreased by 0.4 [-0.5;-0.3] and -0.2 [-0.3;-0.2] points, respectively. Serum procalcitonin and C-reactive protein levels showed significant reduction: -15.4 [-19.6;-11.17] ng/mL; -17,52 [-70;44] mg/L, respectively. In the septic cohort PCT and IL-6 also showed significant reduction: -18.2 [-23.6;-12.8] ng/mL; -2.6 [-3.0;-2.2] pg/mL, respectively. Evaluation of the overall effect: minimal improvement (22%), much improvement (22%) and very much improvement (10%), no change observed (30%) and deterioration (4%). There was no significant difference in the primary outcome of mortality, but there were improvements in cardiovascular and pulmonary SOFA scores and a reduction in PCT, CRP and IL-6 levels.

引用

页数：17

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