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Cytokine hemoadsorption with CytoSorb® in patients with sepsis: a systematic review and meta-analysis
OBJECTIVE: To analyze the effect of CytoSorb® on mortality, interleukin levels, vasopressor use and adverse events in patients with sepsis. METHODS: We searched MEDLINE®, Embase and the Cochrane Library for randomized controlled trials and cohort studies that reported the use of CytoSorb® among sept...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Associação de Medicina Intensiva Brasileira - AMIB
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10406402/ https://www.ncbi.nlm.nih.gov/pubmed/37712812 http://dx.doi.org/10.5935/2965-2774.20230289-en |
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author | Saldaña-Gastulo, Jiovany Jhan Carlos Llamas-Barbarán, María del Rosario Coronel-Chucos, Lelis G. Hurtado-Roca, Yamilée |
author_facet | Saldaña-Gastulo, Jiovany Jhan Carlos Llamas-Barbarán, María del Rosario Coronel-Chucos, Lelis G. Hurtado-Roca, Yamilée |
author_sort | Saldaña-Gastulo, Jiovany Jhan Carlos |
collection | PubMed |
description | OBJECTIVE: To analyze the effect of CytoSorb® on mortality, interleukin levels, vasopressor use and adverse events in patients with sepsis. METHODS: We searched MEDLINE®, Embase and the Cochrane Library for randomized controlled trials and cohort studies that reported the use of CytoSorb® among septic patients. The primary outcome was mortality, and secondary outcomes included the use of vasopressors, levels of inflammatory markers, predicted versus observed mortality, length of stay in the intensive care unit, and adverse events. RESULTS: We included 6 studies enrolling 413 patients, and assessment for risk of bias indicated variations in study quality from high to moderate. The overall mortality rate was 45%, and no significant effect on mortality was found at 28 - 30 days (RR 0.98 [0.12 - 8.25] for the randomized clinical trial and RR 0.74 [0.49 - 1.13] for cohort studies). We did not perform a metanalysis for other outcomes due to the small number of studies found or the lack of data. CONCLUSION: Our study found very low certainty evidence, due to imprecision, risk of bias, and heterogeneity, thereby showing no benefit of CytoSorb® use in terms of mortality at 28 - 30 days. We cannot recommend the use of CytoSorb® in septic or septic shock patients outside clinical trials. Further high-quality randomized trials with a common intervention arm are needed to evaluate the influence of CytoSorb® in this population. PROSPERO REGISTER: CRD42021262219 |
format | Online Article Text |
id | pubmed-10406402 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Associação de Medicina Intensiva Brasileira - AMIB |
record_format | MEDLINE/PubMed |
spelling | pubmed-104064022023-08-08 Cytokine hemoadsorption with CytoSorb® in patients with sepsis: a systematic review and meta-analysis Saldaña-Gastulo, Jiovany Jhan Carlos Llamas-Barbarán, María del Rosario Coronel-Chucos, Lelis G. Hurtado-Roca, Yamilée Crit Care Sci Review OBJECTIVE: To analyze the effect of CytoSorb® on mortality, interleukin levels, vasopressor use and adverse events in patients with sepsis. METHODS: We searched MEDLINE®, Embase and the Cochrane Library for randomized controlled trials and cohort studies that reported the use of CytoSorb® among septic patients. The primary outcome was mortality, and secondary outcomes included the use of vasopressors, levels of inflammatory markers, predicted versus observed mortality, length of stay in the intensive care unit, and adverse events. RESULTS: We included 6 studies enrolling 413 patients, and assessment for risk of bias indicated variations in study quality from high to moderate. The overall mortality rate was 45%, and no significant effect on mortality was found at 28 - 30 days (RR 0.98 [0.12 - 8.25] for the randomized clinical trial and RR 0.74 [0.49 - 1.13] for cohort studies). We did not perform a metanalysis for other outcomes due to the small number of studies found or the lack of data. CONCLUSION: Our study found very low certainty evidence, due to imprecision, risk of bias, and heterogeneity, thereby showing no benefit of CytoSorb® use in terms of mortality at 28 - 30 days. We cannot recommend the use of CytoSorb® in septic or septic shock patients outside clinical trials. Further high-quality randomized trials with a common intervention arm are needed to evaluate the influence of CytoSorb® in this population. PROSPERO REGISTER: CRD42021262219 Associação de Medicina Intensiva Brasileira - AMIB 2023 /pmc/articles/PMC10406402/ /pubmed/37712812 http://dx.doi.org/10.5935/2965-2774.20230289-en Text en https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Saldaña-Gastulo, Jiovany Jhan Carlos Llamas-Barbarán, María del Rosario Coronel-Chucos, Lelis G. Hurtado-Roca, Yamilée Cytokine hemoadsorption with CytoSorb® in patients with sepsis: a systematic review and meta-analysis |
title | Cytokine hemoadsorption with CytoSorb® in patients with
sepsis: a systematic review and meta-analysis |
title_full | Cytokine hemoadsorption with CytoSorb® in patients with
sepsis: a systematic review and meta-analysis |
title_fullStr | Cytokine hemoadsorption with CytoSorb® in patients with
sepsis: a systematic review and meta-analysis |
title_full_unstemmed | Cytokine hemoadsorption with CytoSorb® in patients with
sepsis: a systematic review and meta-analysis |
title_short | Cytokine hemoadsorption with CytoSorb® in patients with
sepsis: a systematic review and meta-analysis |
title_sort | cytokine hemoadsorption with cytosorb® in patients with
sepsis: a systematic review and meta-analysis |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10406402/ https://www.ncbi.nlm.nih.gov/pubmed/37712812 http://dx.doi.org/10.5935/2965-2774.20230289-en |
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