Department of Nephrology, University Medical Center Ljubljana, Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Sci Rep. 2023 Aug 18;13(1):13464. doi: 10.1038/s41598-023-40719-z.
Extracorporeal cytokine adsorption aims to reduce cytokine levels in critically ill patients. However, little convincing data exist to support its widespread use. This retrospective study compared interleukin-6 (IL-6) levels in patients treated with or without cytokine adsorber (CytoSorb®). Intensive care patients between Jan 2017 and Dec 2021 who had at least two IL-6 measurements were included. They were divided into an adsorber group and a standard of care group. We screened 3865 patients and included 52 patients in the adsorber group and 94 patients in the standard of care group. Matching was performed and the groups were compared regarding IL-6, lactate, CRP, procalcitonin, vasopressor requirement, and mortality rate. After matching, there were 21 patients in each group. Patients had similar age, ECMO and renal replacement therapy use, baseline noradrenaline requirement, serum lactate, pH, CRP, and IL-6 levels. There were no significant differences in the time course of IL-6, lactate, CRP, procalcitonin and noradrenaline requirement between groups. Two-day and ICU mortality and Kaplan-Meier estimated survival were also comparable. In this matched case-control study no difference in IL-6, inflammatory parameters, noradrenaline requirement or mortality was observed between patients treated with adsorber or standard of care.
体外细胞因子吸附旨在降低危重症患者的细胞因子水平。然而，几乎没有令人信服的数据支持其广泛应用。本回顾性研究比较了接受或未接受细胞因子吸附剂（CytoSorb®）治疗的患者的白细胞介素 6（IL-6）水平。纳入了 2017 年 1 月至 2021 年 12 月期间至少接受两次 IL-6 测量的重症监护患者。他们被分为吸附器组和标准治疗组。我们筛选了 3865 名患者，其中 52 名患者纳入吸附器组，94 名患者纳入标准治疗组。进行了匹配，并比较了两组患者的 IL-6、乳酸、CRP、降钙素原、血管加压素需求和死亡率。匹配后，每组各有 21 名患者。患者的年龄、ECMO 和肾脏替代治疗的使用、基础去甲肾上腺素需求、血清乳酸、pH 值、CRP 和 IL-6 水平相似。两组间 IL-6、乳酸、CRP、降钙素原和去甲肾上腺素需求的时间过程无显著差异。2 天和 ICU 死亡率以及 Kaplan-Meier 估计生存率也相似。在这项匹配的病例对照研究中，接受吸附器或标准治疗的患者之间，IL-6、炎症参数、去甲肾上腺素需求或死亡率无差异。
