Widely used blood purifier shows no proven benefit, finds meta-study (CytoSorb)

Medical Xpress / Medizinische Hochschule Hannover / Critical Care ^ | July 13, 2023 | Sören Becker et al

[ConservativeMind]

Many hospitals use the adsorber to purify the blood of seriously ill patients in order to trap inflammatory substances and prevent the life-threatening cytokine storm. Researchers have now found in a meta-study that the treatment does not reduce mortality and may even cause harm.

Blood purification procedures are used for a variety of diseases such as kidney failure or severe infections.

In these procedures, which usually takes several hours, the blood is passed through a machine to remove pathogens or harmful metabolic products with the help of so-called adsorber systems. The healthy parts are then returned to the patients as an infusion.

But intensive care medicine also uses blood purification procedures to remove pro-inflammatory cytokines from the blood in cases of life-threatening excessive immune reactions caused by sepsis or COVID-19. These proteins actually control the defense against pathogens.

However, when released uncontrollably, they trigger a life-threatening overreaction of the immune system. To prevent this, many hospitals use the CytoSorb adsorber system. The cartridge is supposed to intercept the problematic messenger substances and ensure that those affected survive the dreaded cytokine storm.

Now researchers have examined the effectiveness of the adsorber in more detail for the first time.

They analyzed data from 34 studies in which about 1,300 patients treated with CytoSorb were compared with about 1,300 control subjects. The result: "We could not find any measurable reduction in mortality due to CytoSorb treatment," says Professor Dr. Bernhard Schmidt.

The use of the cartridge, which costs around 1,100 euros more, can even have negative consequences. This is because the adsorber not only removes the pro-inflammatory cytokines, but also other components of the blood plasma such as anti-inflammatory tissue hormones, coagulation factors and antibiotics.

"Therefore, we cannot recommend the use of CytoSorb in intensive care medicine," the nephrologist states.

[ConservativeMind]

It appears it takes out too many necessary blood components, not allowing them to ever return to the body, like apheresis does.

[ConservativeMind]

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[Secret Agent Man]

Perhaps it could be more effective and safer in a lower dose. Or various different doses, depending on what acute issue they are using it for.

[Skywise]

This is just worthless “science” - it’s a meta study based upon the cross analysis of several other studies and drawing a n overall conclusion for which none of the studies were designed to make.

It’s not a matter if using it doesn’t affect overall morality in the ICU if that morality wasn’t caused by Sepsis to begin with. If most of the ICU patients died of, say, heart failure unrelated to sepsis than the studies findings are nonsensical.

If their point is that sepsis isn’t generally a factor in the morality of ~1000 ICU deaths so it shouldn’t be used - that is also a fallacy because sepsis can be a very real issue (and, in fact, they make that point - that it just shouldn’t be a general practice but should be used where it’s necessary and Sepsis is an issue, which also shows that the study was nonsensical - Thanks Captain Obvious)