Ocskay Klementina, Tomescu Dana, Faltlhauser Andreas, Jacob David, Friesecke Sigrun, Malbrain Manu, Kogelmann Klaus, Bogdanski Ralph, Bach Friedhelm, Fritz Harald, Hartjes Andreas, Kortgen Andreas, Soukup Jens, Utzolino Stefan, van Tellingen Martijn, Träger Karl, Schumacher Ulrike, Brunkhorst Frank M, Molnar Zsolt
Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Hungary.
Anesthesiology and Intensive Care, Fundeni Clinical Institute, 022328 Bucharest, Romania.
J Clin Med. 2021 Nov 5;10(21):5182. doi: 10.3390/jcm10215182.
Our aim is to report the results of the 'liver indication' subset of patients in the CytoSorb International Registry.
Structured data were recorded. Treatment characteristics and changes from T1 (start of hemoadsorption) to T2 (termination) were evaluated with a special focus on bilirubin, C-reactive protein, procalcitonin, interleukin-6, platelet levels, SOFA scores, mortality, and subjective assessment by the attending physicians.
Until January 2021, from the total 1434 patients, 109 (age: 49.2 ± 17.1 years, 57.8% males) received treatment for hyperbilirubinemia. APACHE II-predicted mortality was 49.6 ± 26.8%. In the study, 91% of patients were alive at the termination of hemoadsorption and improvement was observed by the physicians in 75 cases. Overall, 65 (59.6%) patients died in the hospital, and 60 (55.0%) died in the ICU. Patients received a median of two treatments for a median of 43 h (interquartile range: 24-72 h) in total. Serum bilirubin levels reduced significantly to -4.6 (95% CI: -6.329 to -2.8) mg/dL. Thrombocytopenia was reported in four patients as an adverse event.
We report the largest case series on hemoadsorption for 'liver indication' from the CytoSorb International Registry. The finding of significant bilirubin removal observed in our study could have substantial impact in designing and executing further studies on the effects of hemoadsorption in liver dysfunction, which are certainly warranted.
我们的目的是报告细胞吸附国际注册研究中“肝脏适应症”亚组患者的结果。
记录结构化数据。评估治疗特征以及从T1（血液吸附开始）到T2（结束）的变化，特别关注胆红素、C反应蛋白、降钙素原、白细胞介素-6、血小板水平、序贯器官衰竭评估（SOFA）评分、死亡率以及主治医生的主观评估。
截至2021年1月，在总共1434例患者中，109例（年龄：49.2±17.1岁，男性占57.8%）接受了高胆红素血症治疗。急性生理与慢性健康状况评分系统（APACHE）II预测的死亡率为49.6±26.8%。在该研究中，91%的患者在血液吸附结束时存活，医生观察到75例患者病情有所改善。总体而言，65例（59.6%）患者在医院死亡，60例（55.0%）在重症监护病房死亡。患者总共接受了中位数为两次的治疗，中位治疗时间为43小时（四分位间距：24 - 72小时）。血清胆红素水平显著降低至-4.6（95%CI：-6.329至-2.8）mg/dL。有4例患者报告出现血小板减少这一不良事件。
我们报告了细胞吸附国际注册研究中关于“肝脏适应症”血液吸附的最大病例系列。我们研究中观察到的胆红素显著清除这一发现，可能会对设计和开展关于血液吸附对肝功能障碍影响的进一步研究产生重大影响，而这些研究无疑是必要的。
