Cytokine adsorption in patients with post-cardiac arrest syndrome after extracorporeal cardiopulmonary resuscitation (CYTER): a single-centre, open-label, randomised, controlled trial
AIM: To investigate the effect of cytokine adsorption in patients receiving extracorporeal cardiopulmonary resuscitation (ECPR) after cardiac arrest. - METHODS: CYTER was a single-centre, open-label, randomised, controlled trial. Patients selected for ECPR at the University Medical Center Freiburg (...
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| Hauptverfasser: | , , , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
7 February 2022
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| In: |
Resuscitation
Year: 2022, Jahrgang: 173, Pages: 169-178 |
| ISSN: | 1873-1570 |
| DOI: | 10.1016/j.resuscitation.2022.02.001 |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.resuscitation.2022.02.001
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| Verfasserangaben: | Alexander Supady, Timm Zahn, Moritz Kuhl, Sven Maier, Christoph Benk, Klaus Kaier, Bernd W. Böttiger, Christoph Bode, Achim Lother, Dawid L. Staudacher, Tobias Wengenmayer, Daniel Duerschmied |
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| 245 | 1 | 0 | |a Cytokine adsorption in patients with post-cardiac arrest syndrome after extracorporeal cardiopulmonary resuscitation (CYTER) |b a single-centre, open-label, randomised, controlled trial |c Alexander Supady, Timm Zahn, Moritz Kuhl, Sven Maier, Christoph Benk, Klaus Kaier, Bernd W. Böttiger, Christoph Bode, Achim Lother, Dawid L. Staudacher, Tobias Wengenmayer, Daniel Duerschmied |
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| 520 | |a AIM: To investigate the effect of cytokine adsorption in patients receiving extracorporeal cardiopulmonary resuscitation (ECPR) after cardiac arrest. - METHODS: CYTER was a single-centre, open-label, randomised, controlled trial. Patients selected for ECPR at the University Medical Center Freiburg (Freiburg, Germany) were assigned to extracorporeal membrane oxygenation (ECMO) support with or without cytokine adsorption (1:1) using the CytoSorb adsorber, incorporated into the ECMO, replaced every 24 hours, and removed after 72 hours. The primary endpoint was serum interleukin (IL)-6 concentration at 72 hours (intention-to-treat analysis). Secondary endpoints included 30-day survival, vasopressor support and biomarkers of end-organ injury. - RESULTS: Of 50 patients enrolled in the trial, 26 (52%) were treated with cytokine adsorption and 24 (48%) without. Nine patients were excluded (informed consent could not be obtained); 41 patients were therefore included in the primary analysis. Median IL-6 levels (IQR) decreased from 408.0(93.4-906.5) to 324.0 (134.3-4617.3) pg/mL and increased from 133.0 (56.2-528.5) to 241.0 (132.8-718.0) pg/mL in the cytokine adsorption and control group, respectively (linear regression for treatment [cytokine adsorption vs control]: p = 0.48). Three (14%) of 22 patients treated with cytokine adsorption and 8 (42%) of 19 patients treated without cytokine adsorption survived to day 30 (HR = 1.85, 95% CI 0.86-4.01; p = 0.10). Vasopressor support and NSE, S100b, troponin T, CRP and PCT levels were similar between groups. - CONCLUSION: Cytokine adsorption in patients receiving ECPR did not reduce serum IL-6 and had no significant effect on survival, vasopressor support, or biomarkers of injury. - CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov: NCT03685383. | ||
| 650 | 4 | |a Adsorption | |
| 650 | 4 | |a Cardiopulmonary Resuscitation | |
| 650 | 4 | |a Cytokine adsorption | |
| 650 | 4 | |a Cytokines | |
| 650 | 4 | |a CytoSorb | |
| 650 | 4 | |a Extracorporeal cardiopulmonary resuscitation | |
| 650 | 4 | |a Extracorporeal Membrane Oxygenation | |
| 650 | 4 | |a Haemoadsorption | |
| 650 | 4 | |a Humans | |
| 650 | 4 | |a Interleukin-6 | |
| 650 | 4 | |a Post-Cardiac Arrest Syndrome | |
| 650 | 4 | |a Retrospective Studies | |
| 650 | 4 | |a Treatment Outcome | |
| 700 | 1 | |a Zahn, Timm |e VerfasserIn |4 aut | |
| 700 | 1 | |a Kuhl, Moritz |e VerfasserIn |4 aut | |
| 700 | 1 | |a Maier, Sven |e VerfasserIn |4 aut | |
| 700 | 1 | |a Benk, Christoph |e VerfasserIn |4 aut | |
| 700 | 1 | |a Kaier, Klaus |e VerfasserIn |4 aut | |
| 700 | 1 | |a Böttiger, Bernd W. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Bode, Christoph |e VerfasserIn |4 aut | |
| 700 | 1 | |a Lother, Achim |e VerfasserIn |4 aut | |
| 700 | 1 | |a Staudacher, Dawid L. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Wengenmayer, Tobias |e VerfasserIn |4 aut | |
| 700 | 1 | |a Duerschmied, Daniel |e VerfasserIn |4 aut | |
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