Hämoadsorption zur Blutreinigung – Unvergleichbarkeit der klinisch angebotenen Verfahren

BACKGROUND: In the field of intensive care medicine, but also increasingly in cardiac surgery, the use of adsorptive blood purification technologies for the treatment of hyperinflammatory conditions is becoming progressively more important. In addition to the CytoSorb concept, which is more and more clinically accepted and currently the most frequently used method, other companies—particularly from China—have recently entered the market with similar concepts. OBJECTIVES: Given this, the aim of this article is to analyze the different aspects of the various hemoadsorption products offered on the market today and to take a critical look at the available evidence. METHODS: Technical features, application-specific characteristics, and the existing evidence of the adsorption technologies CytoSorb® (CytoSorbents(TM) Inc., Monmouth Junction, NJ, USA), Jafron® HA series (Jafron Biomedical Co., Guangdong, China), and Biosky® MG series (Biosun® Medical Technology Co., Foshan City, Guangdong Province, China) were analyzed. The purely substance-specific methods for endotoxin elimination only (Toraymyxin®, Alteco®) were not considered. RESULTS: A comprehensive analysis of these criteria reveals that there are considerable differences between the various available technologies in terms of materials used, adsorption characteristics, application, and available data on safety and clinical experience. Furthermore, it becomes clear that not only the efficacy of blood purification technologies should be considered in terms of an effect–price–performance ratio, but that in particular the safety of the individual technologies is of crucial importance. DISCUSSION: Among the technologies analyzed, CytoSorb currently represents the most investigated and clinically established procedure. Furthermore, it should be noted that clinical results, but particularly safety-relevant aspects, are not transferable between the products due to technically different procedures.