gms | German Medical Science

Sepsis is the primary cause of death from infection. It is common in the aging population, and it mainly affects patients with cancer and underlying immunosuppression as well as trauma, bacterial and fungal toxins. In its most severe form, sepsis causes multiple organ dysfunctions that can produce a state of chronic critical illness characterized by severe immune dysfunction and catabolism. Sepsis induces the activation of complement factor via three pathways and the release of inflammatory cytokines such as tumor necrosis factor alpha (TNF-α) and interleukin-1ßeta (IL-1β) resulting in the so-called systemic inflammatory response syndrome. The inflammatory cytokines and nitric oxide induced by sepsis can decrease systemic vascular resistance, resulting in profound hypotension. The combination of hypotension and microvascular occlusion results in tissue ischemia and ultimately leads to multiple organ failure.

Several clinical and experimental studies have reported that treatment for adsorption of cytokines is beneficial during endotoxemia and sepsis. This review article will analyze the efficacy of CytoSorb adsorber in reducing the inflammatory response during sepsis. The CytoSorb adsorber is known to have excellent adsorption rates for inflammatory cytokines such as IL-1β, IL-6, IL-8, IL-10, and TNF-α. Studies have demonstrated that treatment with cytokine adsorbing columns has beneficial effects on the survival rate and inflammatory responses in animal septic models. Several cases have been reported in which treatment with cytokine adsorbing columns is very effective in the stabilization of organ failure and hemodynamics in critically ill patients. Although further investigations and clinical trials are needed, treatment with cytokine adsorbing columns may play an important role in the treatment of septic events in the near future.