Universität zu Köln

Supady, Alexander, Zahn, Timm, Kuhl, Moritz, Maier, Sven, Benk, Christoph, Kaier, Klaus ORCID: 0000-0003-0837-6945, Boettiger, Bernd W., Bode, Christoph, Lother, Achim, Staudacher, Dawid L., Wengenmayer, Tobias and Duerschmied, Daniel (2022). Cytokine adsorption in patients with post-cardiac arrest syndrome after extracorporeal cardiopulmonary resuscitation (CYTER) - A single-centre, open-label, randomised, controlled trial. Resuscitation, 173. S. 169 - 179. CLARE: ELSEVIER IRELAND LTD. ISSN 1873-1570

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Abstract

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) mu g/mL and increased from 133.0 (56.2-528.5) to 241.0 (132.8-718.0) mu g/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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Supady, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Zahn, Timm UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhl, Moritz UNSPECIFIED UNSPECIFIED UNSPECIFIED Maier, Sven UNSPECIFIED UNSPECIFIED UNSPECIFIED Benk, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Kaier, Klaus UNSPECIFIED orcid.org/0000-0003-0837-6945 UNSPECIFIED Boettiger, Bernd W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bode, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Lother, Achim UNSPECIFIED UNSPECIFIED UNSPECIFIED Staudacher, Dawid L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wengenmayer, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Duerschmied, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-675196
DOI:	10.1016/j.resuscitation.2022.02.001
Journal or Publication Title:	Resuscitation
Volume:	173
Page Range:	S. 169 - 179
Date:	2022
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1873-1570
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SURVIVAL; SURGERY; FAILURE; COUNCIL Multiple languages Critical Care Medicine; Emergency Medicine Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67519