CytoSorbents Corporation (CTSO)

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Use of cytokine filters in cardiopulmonary bypass machines (Einsatz eines Zytokinfilters in die Herz-Lungen-Maschine) Deppe AC, Weber C, Choi YH, Wahlers T. Z Herz- Thorax-Gefäßchir 2016 30(4): 254-259 ??? Abstract and article in German, abstract only in English. Summary: Cardiac surgical interventions using a cardiopulmonary bypass (CPB) machine induce a systemic inflammatory reaction due to activation of multiple inflammatory cascades. In the postoperative phase this can result in systemic inflammatory response syndrome (SIRS). Activation of various mediators of inflammation, such as interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) can lead to postoperative complications, organ dysfunction, morbidity and mortality. The effect of adsorption of cytokines using CytoSorb® with a CPB machine during cardiac surgery is evaluated. The study is being conducted as a prospective, observational pilot study to determine the clinical impact of the use of an adsorption filter (CytoSorb®) on the serum levels of IL-6, IL-8 and TNF-alpha using a CPB machine. This pilot study includes 300 patients planned for elective surgical myocardial revascularization, partitioned into 3 groups each with 100 patients with on-pump myocardial revascularization?with CytoSorb®, on-pump myocardial revascularization without CytoSorb® and off- pump myocardial revascularization. Primary outcome measures are the inflammatory response serum parameters IL-6, IL-8, TNF- alpha, complement C3/C4, leucocyte counts and C-reactive protein. Secondary outcome measures are length of intensive care unit (ICU) and total hospital stay, duration of ventilation, duration of catecholamine therapy, kidney injury as well as major adverse cardiac and cerebrovascular events. Interim analysis after concluding 60 % of the planned patients revealed a well- balanced group allocation of patients. In the group with CytoSorb® the IL-6 values are decreased, whereas TNF-alpha values are comparable between the three groups. There was reduced sternal wound infections and lower usage of antibiotics in the CytoSorb group. The use of the CytoSorb® filter during CPB is safe compared with the standard procedure and applicable without technical difficulties. CytoSorb® reduces the cytokine load and seems to attenuate the inflammatory response. http://link.springer.com/article/10.1007/s00398-016-0075-4