20.500.12556/DiRROS-25165 Interleukin-6 extraction ratios during prolonged CytoSorb hemoadsorption depend on procedural blood flow Background: Hemoadsorption with CytoSorb is a novel treatment for cytokine release syndrome, but there are few published data on the rate of cytokine removal with prolonged use. Here, we report a prospective observational study of IL-6 extraction ratios with prolonged CytoSorb use. Methods: A secondary analysis was conducted on a prospective observational cohort study involving patients treated with CytoSorb. Blood samples for IL-6 were taken before treatment, after 30 min, and every 6 h of treatment at three sites: (1) before the adsorber, (2) between the adsorber and dialyzer, and (3) after the dialyzer. The extraction ratios of the adsorber were then calculated. Results: We included 21 dialysis circuits performed in 15 critically ill patients, mainly those with cytokine storm because of septic shock. The median extraction ratio of IL-6 after 30 min was 26% (interquartile range, IQR 18-37%). The ratio decreased to 10% (6-21%) after 6 h and remained between 9-16% for up to 24 h (with a low number of circuits used beyond 12 h). Extraction ratios were similar in circuits with high (>1,000 ng/L) and low baseline IL-6 levels. On the contrary, in circuits with high blood flow (≥200 mL/min, i.e., intermittent hemodialysis), the extraction ratio was very low (median 6%) at 6 h and negligible thereafter, whereas the circuits with lower blood flow (<200 mL/min) maintained an extraction ratio of 20% for up to 12 h. Conclusion: We observed a significant reduction in the IL-6 extraction ratio within 6 h in circuits with high blood flow, whereas circuits with lower blood flow maintained an adequate extraction ratio for up to 12 h. Recent consensus recommendations on an 8-12 h exchange interval should mainly be applied to continuous dialysis methods, whereas in intermittent hemodialysis, the exchanges should be more frequent. CytoSorb cytokines hemoadsorption interleukin 6 (IL6) reduction ratio removal rate citokini hemoadsorpcija interlevkin 6 (IL6) redukcijsko razmerje hitrost odstranjevanja true false true Angleški jezik Slovenski jezik Neznano 2026-01-13 08:24:40 2026-01-13 08:24:41 2026-03-10 10:28:38 0000-00-00 00:00:00 2025 0 0 Nasl. z nasl. zaslona; Opis vira z dne 31. 12. 2025; str. 1-6 [article no.] 1670620 Vol. 12 Oct. 2025 0000-00-00 Zaloznikova Objavljeno apc 0000-00-00 0000-00-00 0000-00-00 616.1/.4 2296-858X 10.3389/fmed.2025.1670620 263260419 RAZ_Gubensek_Jakob_2025.pdf RAZ_Gubensek_Jakob_2025.pdf 1 B678AC66F5611B2A30C4F445AD6A7E28 6c3630801689bf18525d0c26464f36db628b4c753abf9e5391245f125f1edb18 2ae73a38-f051-11f0-94a7-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=37926 https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1670620/full 1 ee36e35f-f050-11f0-94a7-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=37925 Univerzitetni klinični center Ljubljana 0 0 0