This paper summerizes the final results of the International CytoSorb Registry that was open between 2015 and 2021. 1434 patients were enrolled in total from 46 centres, with the main indication for the use of CytoSorb being sepsis / septic shock (936 pts, 65%), intraoperative use in cardiac surgery (172 pts, 12%), postoperative use after cardiac surgery (67 pts, 5%), and other – like e.g., liver failure, pancreatitis, rhabdomyolysis, drug overdose or ticagrelor / rivaroxaban removal and hemophagocytic lymphohistocytosis (259, 18%). For inclusion in the Registry, there were no specific interventions apart from the use of CytoSorb. Data collection was at four time points – baseline, before treatment with CytoSorb, up to 24 hrs following treatment and hospital discharge. APACHE-II predicted mortality was 62.0±24.8%, whereas observed hospital mortality was 50.1%. Overall Sequential Organ Failure Assessment (SOFA) scores did not change but cardiovascular and pulmonary SOFA scores decreased significantly by 0.4 [-0.5;-0.3] and -0.2 [-0.3;-0.2] points, respectively. Serum procalcitonin and C-reactive protein levels showed significant reduction: -15.4 [-19.6;-11.17] ng/mL; -17,52 [-70;44] mg/L, respectively. In the septic cohort PCT and IL-6 also showed significant reductions: -18.2 [-23.6; -12.8] ng/mL; -2.6 [-3.0;-2.2] pg/mL, respectively. Evaluation of the overall effect by the treating physicians was: minimal improvement (22%), much improvement (22%) and very much improvement (10%), no change observed (30%) and deterioration (4%). In conclusion, this study represents the largest systematic data collection on the clinical use of CytoSorb to date. Although there was no significant difference in mortality when comparing actual mortality with APACHE II predicted (primary outcome), there were significant improvements in cardiovascular and pulmonary components of the SOFA score and reductions in the inflammatory parameters, PCT, CRP and IL-6. Registry data also suggests that the use of CytoSorb is safe.
Open-access publication: https://pubmed.ncbi.nlm.nih.gov/36282800/