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Hemoperfusion with Cytosorb in pediatric patients with septic shock: A retrospective observational study

Gabriella Bottari1, Isabella Guzzo2, Marco Marano1

  • 1Pediatric Intensive Care Unit, Children's Hospital Bambino Gesù, Rome, Italy.

The International Journal of Artificial Organs
|February 1, 2020
PubMed

Insights

Continuous hemoperfusion with Cytosorb and Continuous Renal Replacement Therapy rapidly stabilized hemodynamics in pediatric septic shock. This extracorporeal blood purification significantly reduced key inflammatory markers, improving patient outcomes.

Area of Science:

  • Critical Care Medicine
  • Pediatric Intensive Care
  • Extracorporeal Blood Purification

Background:

  • Septic shock in children presents significant hemodynamic instability and high mortality.
  • Continuous Renal Replacement Therapy (CRRT) is a standard treatment, but adjunctive therapies are needed to manage inflammation.
  • Cytosorb hemoperfusion offers a potential strategy to remove inflammatory mediators during CRRT.

Purpose of the Study:

  • To evaluate the clinical efficacy of continuous hemoperfusion with Cytosorb alongside CRRT in pediatric septic shock.
  • To assess the impact on hemodynamic parameters and relevant clinical outcomes.
  • To analyze the reduction in specific pro-inflammatory cytokines.

Main Methods:

  • Retrospective analysis of eight pediatric patients with septic shock undergoing CRRT with Cytosorb.
  • Cytosorb adsorber was replaced every 24 hours.
  • Hemodynamic status (Vasoactive-Inotropic Score) and cytokine levels (IL-6, IL-10, TNF-alpha) were monitored.

Main Results:

  • A significant improvement in Vasoactive-Inotropic Score was observed post-treatment (p=0.0076).
  • Plasma levels of interleukin-6 and interleukin-10 were significantly reduced (p=0.0077 and p=0.0180, respectively).
  • Pediatric intensive care unit survival was 90% in the cohort.

Conclusions:

  • Cytosorb combined with CRRT rapidly stabilizes hemodynamics in pediatric septic shock within 48 hours.
  • This blood purification strategy effectively reduces key inflammatory cytokines, IL-6 and IL-10.
  • The treatment shows promise as an adjunctive therapy for severe pediatric sepsis.
Abstract

Keywords:
Blood purificationCytosorbcytokineshemoperfusionpediatric intensive careseptic shock

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