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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 PLoS+One
2017 ; 12
(10
): e0187015
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The effect of a novel extracorporeal cytokine hemoadsorption device on IL-6
elimination in septic patients: A randomized controlled trial
#MMPMID29084247
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 JA
; Kuhlmann MK
PLoS One
2017[]; 12
(10
): e0187015
PMID29084247
show ga
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.