In this interdisciplinary debate article, the use of extracorporeal membrane oxygenation (ECMO) around the world for various indications is initially described with prognosis often poor even with all the supportive therapies. Clinical deterioration is often associated with inflammation. Hemoadsorption with CytoSorb is discussed as a way to limit this inflammatory response, as the device can be safely and easily installed into ECMO circuits. CytoSorb has been used more than 130,000 times to date, but since randomized controlled trials are largely lacking, there is substantial debate on its use. Several experts from critical care medicine, cardiology, cardiac surgery, and perfusion technology discussed the pros and cons of CytoSorb therapy and outline future aspects for its clinical application and research. For example, it is recommended that future studies look at defining a better starting point for CytoSorb integration and duration of use, and the fact that ECMO per se is not a reason to start CytoSorb, rather the underlying pathological condition. Potential fields of application are listed as e.g., profound shock on ECMO, extracorporeal cardio-pulmonary resuscitation, post-cardiotomy ECMO in patients with infection and ECMO in the context of organ donation.
Open-access publication: https://pubmed.ncbi.nlm.nih.gov/34152637/