CytoSorbents Corporation (CTSO)

[andy55q]

CytoSorb - Polymer-based system for adsorbing cytokines

Column CytoSorb
Attention! The system is a consumable item for single use only!

CytoSorb system - nonpyrogenic sterile biocompatible system for a single application designed for the removal of cytokines from the patient's blood by adsorption of using polymeric adsorbent peas contained within the system. A container with an adsorbent CytoSorb secured in a holder on the bar or IV pole, then use CytoSorb adapters connected to the extracorporeal circuit (mains) Blood Pump. The system works with any commercially available blood pump capable of providing flow rates up to 400 mL / min: it can be heart-lung machine, the machine of extracorporeal membrane oxygenation, apparatus for continuous renal replacement therapy, hemodialysis machine. Indications for use CytoSorb system: CytoSorb shows for use in cases of "cytokine storm", ie uncontrolled and not carrying the protective function of the activation of immune cells by cytokines in inflammation and the release of the latest new portion of cytokines due to the direct link between these processes. This occurs in the following cases: sepsis of any etiology; acute respiratory distress syndrome; during operations in cardiovascular and thoracic surgery; in septic patients with gipervospaleniem; in patients after surgery with severe sepsis and acute kidney damage beginning; in patients with acute concomitant diseases and sepsis (a weakened immune system), patients on chronic dialysis; in patients with chronic liver disease. The principle of operation CytoSorb system: Whole blood of the patient, anticoagulated with heparin or citrate throughput CytoSorb, mounted in a holder and connected via adapters in the standard line the blood pump (pump must be able to provide blood flow to 400 ml / min and have a pressure sensor in the lines). Inside CytoSorb occurs hydrophobic interactions (the molecules are drawn into the pores of the material selectively substances with a high concentration of adsorbed more strongly than the substance with a low concentration) spanning proteins average molecular weight, such as cytokines, peas adsorbent into the pores, depending on their concentration in the blood. Adsorbed CytoSorb cytokines remain in the system. More blood on highways perfusion pump returned to the patient. The pore size of the adsorbent within the peas systems allow particles to adsorb a molecular weight of about 8 to 55 kDa. Thus albumin and other proteins of high molecular weight remain in the patient's blood while other sorbents absorb and albumin. The adsorption particles CytoSorb system: The following is a graph illustrating various kinds of cytokines, which are subjected to adsorption using CytoSorb system indicating their sizes . Blue parabola CytoSorb designates the action system. Comments to the scheme: the white color on the chart denote proinflammatory cytokines yellow -protivovospalitelnye cytokines (IL-1ra, IL-13, IL-10, IL-4, TGF- ß), and soluble receptor sTNFR tumor necrosis factor, which is anti-inflammatory mediator. The height of the vertical columns scheme bears no semantic load. Other molecules whose concentration is reduced by CytoSorb: - myoglobin (molecular weight of 17 kDa) . - Bilirubin (MW 8 kD) CytoSorb on blood electrolyte balance is not affected. (D. Shedler et al. Journal of Critical Care 2013, 17 (Supplement 2): P.62 / D Schädler, et al; Critical Care 2013, 17 (Suppl 2):. P62) albumin minialny losses and account for less than 5% (D. Shedler etc. Magazine. critical Care 2013, 17 (Supplement 2): P.62 / D Schädler, et al; critical Care 2013, 17 (Suppl 2):. P62) The levels of C3a and C5b-9 (important quickly produced after the activation of the complement system proteins) in plasma are not rising, that is the use of CytoSorb does not trigger an immune cascade. An additional, apart from the standard, the level of monitoring of the concentration of cytokines during the use of the System is not required.

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