CytoSorb Therapy - Global Decision Support for COVID-19 Patients
Experiences showed that the use of CytoSorb can help the body to fight the harmful effects of COVID-19, if one or more of the following criteria is met:
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- Pronounced vasoplegia (NE > 0.3 µg/kg/min, lactate ↑ ) without response to standard therapy (start of CytoSorb within the first 6 to maximum 24 hours)
- Moderate ARDS
- AKI III with start of CVVH (CRRT)
- H-Score suggesting diagnosis of secondary HLH
- CytoSorb is to be employed as an adjunctive therapy to reduce effects caused by a cytokine storm, not as a primary therapy
removing the virus. Due to its concentration dependency CytoSorb does not completely eliminate inflammatory mediators from the body but rebalances the immune system to more physiologic levels. - CytoSorb can be integrated in many extracorporeal blood circuit: standard clinical renal replacement therapy (CRRT), continuous dialysis and hemofiltration.
Alternatively, use in stand-alone hemoperfusion is possible. - Treatment duration and indication for exchange of adsorber depends on the clinical course.
It is approved for a maximum treatment time of 24 hours. - Usual contraindications for extracorporeal blood circuits apply.
- Installation must never be into the main-stream of an ECMO circuit, pressure or flow monitoring of CytoSorb line is recommended.
- Recommended blood flow rate 150-700 ml/min with a minimal flow of 100ml/min. Ideal flow rates using CRRT with systemic heparin anticoagulation were shown to be 200-250 ml/min.
- Higher flow rates generally result in higher adsorption efficacy.