Immunomodulation by hemoadsorption

  • Background: Sepsis is often associated with liver dysfunction, which is an indicator of poor outcomes. Specific diagnostic tools that detect hepatic dysfunction in its early stages are scarce. So far, the immune modulatory effects of hemoadsorption with \(CytoSorb^{®}\) on liver function are unclear. Method: We assessed the hepatic function by using the dynamic \(LiMAx^{®}\) test and biochemical parameters in 21 patients with sepsis or septic shock receiving \(CytoSorb^{®}\) in a prospective, observational study. Points of measurement: T\(_1\): diagnosis of sepsis or septic shock; T\(_2\) and T\(_3\): 24 h and 48 h after the start of \(CytoSorb^{®}\); T\(_4\): 24 h after termination of \(CytoSorb^{®}\). Results: The hepatic biotransformation capacity measured by \(LiMAx^{®}\) was severely impaired in up to 95 % of patients. Despite a rapid shock reversal under \(CytoSorb^{®}\), a significant improvement in \(LiMAx^{®}\) values appeared from T\(_3\) to T\(_4\). This decline and recovery of liver function were not reflected by common parameters of hepatic metabolism that remained mostly within the normal range. Conclusions: Hepatic dysfunction can effectively and safely be diagnosed with \(LiMAx^{®}\) in ventilated ICU patients under \(CytoSorb^{®}\). Various static liver parameters are of limited use since they do not adequately reflect hepatic dysfunction and impaired hepatic metabolism.

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Metadaten
Author:Janina PraxenthalerORCiDGND, Elke Ute SchwierORCiDGND, Simon AltmannORCiDGND, Carmen KirchnerORCiDGND, Julian BialasGND, Dietrich HenzlerORCiDGND, Thomas KöhlerORCiDGND
URN:urn:nbn:de:hbz:294-103017
DOI:https://doi.org/10.3390/biomedicines10102340
Parent Title (English):Biomedicines
Subtitle (English):changes in hepatic biotransformation capacity in sepsis and septic shock : a prospective study
Publisher:MDPI
Place of publication:Basel, Schweiz
Document Type:Article
Language:English
Date of Publication (online):2023/10/27
Date of first Publication:2022/09/20
Publishing Institution:Ruhr-Universität Bochum, Universitätsbibliothek
Tag:Open Access Fonds
Interleukin-6; \(CytoSorb^{®}\); \(LiMAx^{®}\); dynamic liver function test; hemoadsorption; hepatic dysfunction; sepsis; sepsis-associated liver dysfunction; septic shock; static liver parameters
Volume:10
Issue:10, Article 2340
First Page:2340-1
Last Page:2340-20
Note:
Article Processing Charge funded by the Deutsche Forschungsgemeinschaft (DFG) and the Open Access Publication Fund of Ruhr-Universität Bochum.
Institutes/Facilities:Klinikum Herford, Universitätsklinik für Anästhesiologie, operative Intensiv-, Rettungsmedizin und Schmerztherapie
Dewey Decimal Classification:Technik, Medizin, angewandte Wissenschaften / Medizin, Gesundheit
open_access (DINI-Set):open_access
Licence (English):License LogoCreative Commons - CC BY 4.0 - Attribution 4.0 International