Shah MS, Sharma VV, Patel SJ, Ansari AS. Retrospective evaluation of efficacy of CytoSorb® therapy in septic shock patients in a tertiary care intensive care unit. World J Crit Care Med 2025; 14(4): 105600 [DOI: 10.5492/wjccm.v14.i4.105600]
Corresponding Author of This Article
Abdul S Ansari, MD, Director, Critical Care Medicine, Nanavati Max Super Speciality Hospital, Swami Vivekananda Road, Vile Parle (West), Mumbai 400056, Mahārāshtra, India. drabdulansari@gmail.com
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 9, 2025 (publication date) through Dec 6, 2025
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Critical Care Medicine
ISSN
2220-3141
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Shah MS, Sharma VV, Patel SJ, Ansari AS. Retrospective evaluation of efficacy of CytoSorb® therapy in septic shock patients in a tertiary care intensive care unit. World J Crit Care Med 2025; 14(4): 105600 [DOI: 10.5492/wjccm.v14.i4.105600]
World J Crit Care Med. Dec 9, 2025; 14(4): 105600 Published online Dec 9, 2025. doi: 10.5492/wjccm.v14.i4.105600
Retrospective evaluation of efficacy of CytoSorb® therapy in septic shock patients in a tertiary care intensive care unit
Mayur S Shah, Vedika V Sharma, Syed J Patel, Abdul S Ansari
Mayur S Shah, Vedika V Sharma, Syed J Patel, Abdul S Ansari, Critical Care Medicine, Nanavati Max Super Speciality Hospital, Mumbai 400056, Maharashtra, India
Author contributions: Ansari AS was involved in project supervision, guidance, conceptualization, research design, manuscript drafting, manuscript review, and manuscript finalization; Shah MS performed conceptualization, study design, data interpretation, manuscript writing, critical revision, and manuscript finalization; Sharma VV and Patel SJ for data collection, data analysis, manuscript writing, manuscript finalization.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of our institution (Approval no. BNH/2023/2019).
Informed consent statement: The informed consent is not applicable as the study under consideration is retrospective in nature, and the data involved in the entire process is completely anonymised.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Abdul S Ansari, MD, Director, Critical Care Medicine, Nanavati Max Super Speciality Hospital, Swami Vivekananda Road, Vile Parle (West), Mumbai 400056, Mahārāshtra, India. drabdulansari@gmail.com
Received: January 30, 2025 Revised: May 8, 2025 Accepted: August 6, 2025 Published online: December 9, 2025 Processing time: 303 Days and 22.1 Hours
Abstract
BACKGROUND
Cytokines and inflammatory mediators are the key factors that are involved in the pathology of sepsis. Extracorporeal cytokine hemoadsorption devices offer an innovative clinical support system to alleviate the effects of the cytokine storm associated with sepsis.
AIM
To retrospectively evaluate the efficacy of CytoSorb® therapy as an adjunct to standard care in intensive care unit (ICU) patients with septic shock.
METHODS
A retrospective study was designed. Data were obtained for the patients who were treated with the CytoSorb® adsorber for the past 5 years. The effects of therapy were assessed by changes in vasopressor requirements, specifically, norepinephrine and epinephrine. In addition, cytokine levels, such as interleukin (IL)-6 and inflammatory biomarkers including C-reactive protein (CRP), procalcitonin, as well as substances such as serum lactate and lactate dehydrogenase were also evaluated. In addition, mean arterial pressure (MAP) and ventilator requirements were also recorded. The survival outcomes were analyzed based on the length of patients' stay in the ICU, and the severity of illness was assessed using Acute Physiology and Chronic Health Evaluation (APACHE II) and Sepsis-associated Organ Failure Assessment (SOFA) scores recorded at baseline and post-therapy.
RESULTS
Following CytoSorb® therapy, the requirement for vasopressor drugs, particularly norepinephrine, was reduced by 40% and a statistically significant improvement in MAP by 7.8%. Additionally, significant reductions were observed in IL-6 and serum lactate levels by 83% and 52% respectively. Around 56% had a delta lactate score of > 1.5, while 23% patients had a score ranging from 1 to < 1.5, and 16% patients had a score between 0.5 and < 1 and merely 5% patients had a score of ≤ 0.5. Besides, serum levels of creatinine, procalcitonin and CRP were significantly reduced by 17.2%, 41.5% and 53.8% respectively. There was a significant reduction in scores, including APACHE II [to 23 (18-29) from 27 (23-33)], and SOFA [to 12 (10-14) from 13 (11-15)]. Mechanical ventilation was required by 96% patients, with a median duration of 12 days, and the median length of hospital stay in overall patients was 26 days, while the median ICU stay was 18 days.
CONCLUSION
CytoSorb® therapy seems to be a promising adjunctive approach in the management of septic shock.
Core Tip: CytoSorb® is an innovative extracorporeal cytokine hemoadsorption device designed to stabilize hemodynamic parameters and regulate the cytokine storm in sepsis. This retrospective study evaluated the efficacy of CytoSorb® hemoadsorption therapy as an adjunct to standard care in intensive care unit patients with septic shock. The findings indicate significant reductions in inflammatory biomarkers, vasopressor requirements, along with improvements in organ recovery and survival outcomes. Additionally, no major adverse events were reported in patients receiving the therapy. The study underscores CytoSorb® ability to modulate hyperinflammation from cytokine storms and stabilize hemodynamics, thus facilitating early shock reversal, and improving clinical outcomes in critically ill patients.
