Y Kobe1, S Oda, K Matsuda, M Nakamura, H Hirasawa. 1. Department of Emergency and Critical Care Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan. y-kobe@umin.ac.jp
Abstract
BACKGROUND/AIMS: Cytokine overproduction has been noted during the aggravation of clinical conditions. Countermeasures to control hypercytokinemia are therefore important in critical care. We investigated the clinical efficacy of hemoadsorption therapy using a new cytokine-adsorbing device in critically ill patients with persistent or severe hypercytokinemia. METHODS: Direct hemoperfusion using the CYT-860, a cytokine-adsorber column (CYT-860-DHP), was performed in critically ill patients with hypercytokinemia. To evaluate the efficacy of CYT-860-DHP, changes in pathological and clinical parameters were examined. RESULTS:Seven patients with hypercytokinemia and a SOFA score of > or = 5 underwent CYT-860-DHP treatment. Four patients survived 28 days after CYT-860-DHP treatment. Significant decreases in blood levels of cytokines were observed. PaO2/F(I)O2 improved significantly. CONCLUSION: The possibility that CYT-860-DHP treatment can reduce blood cytokine levels and thereby improve the general condition of patients was suggested. These findings warrant the initiation of a prospective randomized trial to evaluate the clinical efficacy of CYT-860-DHP treatment. 2007 S. Karger AG, Basel
RCT Entities:
BACKGROUND/AIMS: Cytokine overproduction has been noted during the aggravation of clinical conditions. Countermeasures to control hypercytokinemia are therefore important in critical care. We investigated the clinical efficacy of hemoadsorption therapy using a new cytokine-adsorbing device in critically illpatients with persistent or severe hypercytokinemia. METHODS: Direct hemoperfusion using the CYT-860, a cytokine-adsorber column (CYT-860-DHP), was performed in critically illpatients with hypercytokinemia. To evaluate the efficacy of CYT-860-DHP, changes in pathological and clinical parameters were examined. RESULTS: Seven patients with hypercytokinemia and a SOFA score of > or = 5 underwent CYT-860-DHP treatment. Four patients survived 28 days after CYT-860-DHP treatment. Significant decreases in blood levels of cytokines were observed. PaO2/F(I)O2 improved significantly. CONCLUSION: The possibility that CYT-860-DHP treatment can reduce blood cytokine levels and thereby improve the general condition of patients was suggested. These findings warrant the initiation of a prospective randomized trial to evaluate the clinical efficacy of CYT-860-DHP treatment. 2007 S. Karger AG, Basel
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