| Title: | Interleukin-6 extraction ratios during prolonged CytoSorb hemoadsorption depend on procedural blood flow |
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| Authors: | ID Gubenšek, Jakob (Author)
ID Vajdič Trampuž, Barbara (Author)
ID Zrimšek, Matej (Author)
ID Peršič, Vanja (Author) |
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| Files: |  PDF - Presentation file, download (1,47 MB)
MD5: B678AC66F5611B2A30C4F445AD6A7E28
 URL - Source URL, visit https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1670620/full
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| Language: | English |
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| Typology: | 1.01 - Original Scientific Article |
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| Organization: |  UKC LJ - Ljubljana University Medical Centre
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| Abstract: | 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. |
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| Keywords: | CytoSorb, cytokines, hemoadsorption, interleukin 6 (IL6), reduction ratio, removal rate |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Year of publishing: | 2025 |
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| Number of pages: | str. 1-6 |
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| Numbering: | Vol. 12, [article no.] 1670620 |
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| PID: | 20.500.12556/DiRROS-25165  |
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| UDC: | 616.1/.4 |
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| ISSN on article: | 2296-858X |
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| DOI: | 10.3389/fmed.2025.1670620 |
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| COBISS.SI-ID: | 263260419 |
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| Note: | Nasl. z nasl. zaslona;
Opis vira z dne 31. 12. 2025; |
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| Publication date in DiRROS: | 13.01.2026 |
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| Views: | 165 |
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| Downloads: | 91 |
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