Direct hemoperfusion with a cytokine-adsorbing device for the treatment of persistent or severe hypercytokinemia: a pilot study.
OBJECTIVE
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.


CONCLUSIONS
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.
Department of Emergency and Critical Care Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan. y-kobe@umin.ac.jp
Y
Y
Kobe
S
S
Oda
K
K
Matsuda
M
M
Nakamura
H
H
Hirasawa
D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness; D016207:Cytokines / Q000097:blood*; D004867:Equipment Design; D005260:Female; D006464:Hemoperfusion / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000032:analysis; D010313:Partial Pressure; D010865:Pilot Projects; D015996:Survival Rate; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology; D016896:Treatment Outcome
D016207:Cytokines; D010100:Oxygen