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The addition of Cytosorb in patients on VA-ECMO improves urinary output and ICU survival

Daniel Lovrić1, Marijan Pašalić1, Stefan Križanac2

  • 1Cardiology Clinic, University Hospital Center Zagreb, Zagreb, Croatia.

Therapeutic Apheresis and Dialysis : Official Peer-Reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
|September 12, 2023
PubMed

Insights

CytoSorb adsorber use in patients with cardiogenic shock on venoarterial extracorporeal membrane oxygenation (VA-ECMO) reduced vasopressor needs and improved urine output. This therapy showed a trend towards better survival rates.

Area of Science:

  • Critical Care Medicine
  • Cardiovascular Surgery
  • Biomedical Engineering

Background:

  • Cardiogenic shock is a life-threatening condition often requiring mechanical circulatory support.
  • Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a critical treatment for severe cardiogenic shock.
  • Optimizing VA-ECMO therapy involves managing complications and improving patient outcomes.

Purpose of the Study:

  • To evaluate the efficacy of the CytoSorb adsorber in patients with cardiogenic shock undergoing VA-ECMO.
  • To assess the impact of CytoSorb on vasopressor requirements, fluid balance, and lactate levels.
  • To investigate the effect of CytoSorb on mortality rates in this patient population.

Main Methods:

  • A cohort of 16 patients with cardiogenic shock treated with VA-ECMO was analyzed.
  • Patients were stratified based on the early (within 24 hours) use of the CytoSorb adsorber.
  • Clinical outcomes, including vasopressor doses, urine output, lactate levels, and mortality, were compared between groups.

Main Results:

  • Patients treated with CytoSorb required significantly lower vasopressor doses.
  • Early CytoSorb use was associated with higher urine output before VA-ECMO weaning.
  • Lactate levels were lower during extracorporeal support, and the mortality rate was reduced in the CytoSorb group (22.2% vs. 57.1%).

Conclusions:

  • CytoSorb adsorber use in VA-ECMO for cardiogenic shock is associated with decreased vasopressor dependency.
  • This study provides evidence for improved urinary output and a trend toward better survival with CytoSorb therapy.
  • CytoSorb represents a potential adjunctive therapy to improve outcomes in critically ill patients on VA-ECMO.
Abstract

Keywords:
Cytosorbhemoperfusionsurvivalvenoarterial ECMO

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