Interleukin-6 extraction ratios during prolonged CytoSorb hemoadsorption depend on procedural blood flow

Gubenšek, Jakob (avtor), Vajdič Trampuž, Barbara (avtor), Zrimšek, Matej (avtor), Peršič, Vanja (avtor)

Background: Hemoadsorption with CytoSorb is a novel treatment for cytokine release syndrome, but there are few published data on the rate of cytokine removal with prolonged use. Here, we report a prospective observational study of IL-6 extraction ratios with prolonged CytoSorb use. Methods: A secondary analysis was conducted on a prospective observational cohort study involving patients treated with CytoSorb. Blood samples for IL-6 were taken before treatment, after 30 min, and every 6 h of treatment at three sites: (1) before the adsorber, (2) between the adsorber and dialyzer, and (3) after the dialyzer. The extraction ratios of the adsorber were then calculated. Results: We included 21 dialysis circuits performed in 15 critically ill patients, mainly those with cytokine storm because of septic shock. The median extraction ratio of IL-6 after 30 min was 26% (interquartile range, IQR 18-37%). The ratio decreased to 10% (6-21%) after 6 h and remained between 9-16% for up to 24 h (with a low number of circuits used beyond 12 h). Extraction ratios were similar in circuits with high (>1,000 ng/L) and low baseline IL-6 levels. On the contrary, in circuits with high blood flow (≥200 mL/min, i.e., intermittent hemodialysis), the extraction ratio was very low (median 6%) at 6 h and negligible thereafter, whereas the circuits with lower blood flow (<200 mL/min) maintained an extraction ratio of 20% for up to 12 h. Conclusion: We observed a significant reduction in the IL-6 extraction ratio within 6 h in circuits with high blood flow, whereas circuits with lower blood flow maintained an adequate extraction ratio for up to 12 h. Recent consensus recommendations on an 8-12 h exchange interval should mainly be applied to continuous dialysis methods, whereas in intermittent hemodialysis, the exchanges should be more frequent.

• Jezik: Angleški jezik
• Ključne besede: CytoSorb, cytokines, hemoadsorption, interleukin 6 (IL6), reduction ratio, removal rate
• Vrsta gradiva: Članek v reviji
• Tipologija: 1.01 - Izvirni znanstveni članek
• Organizacija: MF - Medicinska fakulteta
• Status publikacije: Objavljeno
• Različica publikacije: Objavljena publikacija
• Leto izida: 2025
• Št. strani: 6 str.
• Številčenje: Vol. 12, art. 1670620
• PID: 20.500.12556/RUL-177974
• UDK: 616.1/.4
• ISSN pri članku: 2296-858X
• DOI: 10.3389/fmed.2025.1670620
• COBISS.SI-ID: 263260419
• Datum objave v RUL: 15.01.2026

Gradivo je del revije

• Naslov: Frontiers in medicine
• Skrajšan naslov: Front. med.
• Založnik: Frontiers Media
• ISSN: 2296-858X
• COBISS.SI-ID: 523095065

Licence

• Licenca: CC BY 4.0, Creative Commons Priznanje avtorstva 4.0 Mednarodna
• Povezava: http://creativecommons.org/licenses/by/4.0/deed.sl
• Opis: To je standardna licenca Creative Commons, ki daje uporabnikom največ možnosti za nadaljnjo uporabo dela, pri čemer morajo navesti avtorja.

Sekundarni jezik

• Jezik: Slovenski jezik
• Ključne besede: CytoSorb, citokini, hemoadsorpcija, interlevkin 6 (IL6), redukcijsko razmerje, hitrost odstranjevanja

Projekti

• Financer: ARIS - Javna agencija za znanstvenoraziskovalno in inovacijsko dejavnost Republike Slovenije
• Številka projekta: P3-0323
• Naslov: Ledvične bolezni in nadomestna zdravljenja