Evidence map›Paper›PMID 31533846›Full record

ArticleCritical care (London, England)2019

Hemoadsorption with CytoSorb shows a decreased observed versus expected 28-day all-cause mortality in ICU patients with septic shock: a propensity-score-weighted retrospective study.

Willem Pieter Brouwer, Servet Duran, Martijn Kuijper, Can Ince

2 registry-linked trialsAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Critical care (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 106 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
106citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04742764 phase3suspendednot on this mapstarted 2024, after this paper: background citation

Dosing of Extracorporeal Cytokine Removal In Septic Shock (DECRISS): a Prospective, Randomized, Multicenter Clinical Trial

TypeinterventionalSponsorUniversity of PecsRan2024 to 2027Enrolled135ConditionsSeptic ShockArmsStandard medical therapy, Standard medical therapy plus cytokine removal treatment using Cytosorb, with the adsorber changed in every 12 hours, Standard medical therapy plus cytokine removal treatment using Cytosorb, with the adsorber changed in every 24 hours
NCT06374121 narecruitingnot on this mapstarted 2024, after this paper: background citation

A Single-center, Pilot, Prospective, Randomized Clinical Study of Hypothermic Oxygenated Perfusion With or Without Adsorption in Histologically Evaluated Kidneys Retrieved From Marginal Donors

TypeinterventionalSponsorMario Negri Institute for Pharmacological ResearchRan2024 to 2026Enrolled10ConditionsKidney ReplacementArmsPerSorb cartridge (CytoSorbents Europe GmbH, Germany), PerLife PerKidney
3 · Its place in the literature

Who cites it

106 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Review
  7. Antibiotics and Other Drugs Removal by the CytoSorbAntibiotics (Basel, Switzerland) · 2026
    Review
  8. Review
  9. Review
  10. Article
  11. Review
  12. Article
  13. Review
  14. Retrospective evaluation of efficacy of CytoSorbWorld journal of critical care medicine · 2025
    Article
  15. Article
  16. Review
  17. Article
  18. Article
  19. Review
  20. Review

46 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Willem Pieter BrouwerDepartment of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 15, Building NA-6, 3015, CE, Rotterdam, The Netherlands. w.p.brouwer@erasmusmc.nl.ORCID http://orcid.org/0000-0001-8713-1481
Servet DuranDepartment of Intensive Care Medicine, Maasstad Ziekenhuis, Rotterdam, The Netherlands.
Martijn KuijperScience board, Maasstad Ziekenhuis, Rotterdam, The Netherlands.
Can InceDepartment of Intensive Care Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsInnovative treatment modalities have not yet shown a clinical benefit in patients with septic shock. To reduce severe cytokinaemia, CytoSorb as an add-on to continuous renal replacement therapy (CRRT) showed promising results in case reports. However, there are no clinical trials investigating outcomes.

methodsIn this investigator-initiated retrospective study, patients with septic shock were treated with CRRT + CytoSorb (n = 67) or CRRT alone (n = 49). The primary outcome was the 28-day all-cause mortality rate. Patients were weighted by stabilized inverse probability of treatment weights (sIPTW) to overcome differences in baseline characteristics.

resultsAt the start of therapy, CytoSorb-treated patients had higher lactate levels (p < 0.001), lower mean arterial pressure (p = 0.007) and higher levels of noradrenaline (p < 0.001) compared to the CRRT group. For CytoSorb, the mean predicted mortality rate based on a SOFA of 13.8 (n = 67) was 75% (95%CI 71-79%), while the actual 28-day mortality rate was 48% (mean difference - 27%, 95%CI - 38 to - 15%, p < 0.001). For CRRT, based on a SOFA of 12.8 (n = 49), the mean predicted versus observed mortality was 68% versus 51% (mean difference - 16.9% [95%CI - 32.6 to - 1.2%, p = 0.035]). By sIPTW analysis, patients treated with CytoSorb had a significantly lower 28-day mortality rate compared to CRRT alone (53% vs. 72%, respectively, p = 0.038). Independent predictors of 28-day mortality in the CytoSorb group were the presence of pneumosepsis (adjusted odds ratio [aOR] 5.47, p = 0.029), higher levels of lactate at the start of CytoSorb (aOR 1.15, p = 0.031) and older age (aOR per 10 years 1.67, p = 0.034).

conclusionsCytoSorb was associated with a decreased observed versus expected 28-day all-cause mortality. By IPTW analysis, intervention with CytoSorb may be associated with a decreased all-cause mortality at 28 days compared to CRRT alone.

Indexed as

Hospital MortalityAbsorption, PhysiologicalAgedContinuous Renal Replacement TherapyCytokinesEquipment DesignFemaleHemofiltrationHumansIntensive Care UnitsMaleMiddle AgedOdds RatioOrgan Dysfunction ScoresPropensity ScoreRetrospective StudiesCytokinesCytosorbCytosorbentHemofiltrationMortalityOutcomeSepsisSeptic shockTreatment

Identifiers

PMID31533846
PMCPMC6749645

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.