ArticleAnnals of intensive care2024
Myoglobin adsorption and saturation kinetics of the cytokine adsorber Cytosorb® in patients with severe rhabdomyolysis: a prospective trial.
Article in Annals of intensive care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04913298 (Prospective Quality Assurance Study for the Application of Cytosorb® in Patients With Cytokine Storm, Rhabdomyolysis and Acute Liver Failure), which is not on this map. Cited by 15 papers.
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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.
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.
Prospective Quality Assurance Study for the Application of Cytosorb® in Patients With Cytokine Storm, Rhabdomyolysis and Acute Liver Failure
Who cites it
15 citing papers in PubMed.
- Kidney REPLACEment therapies in patients with acute kidney injury and RHABDOmyolysis (ReplaceRhabdo): a pilot trial.BMC nephrology · 2025Trial
- Excessive Apixaban Concentrations in a Bleeding Patient Treated With Pharmacological Reversal and Extracorporal Removal-A Case Report.Pharmacology research & perspectives · 2026Article
- Article
- Crocins ameliorate acute kidney injury in glycerol-induced rhabdomyolysis by targeting the PLIN1/PPARs signaling pathway.Frontiers in pharmacology · 2026Article
- Article
- Angiopoietin-2 adsorption attempt with the cytokine adsorber cytosorb in critically ill patients.Scientific reports · 2025Article
- Preventing acute kidney injury and its longer-term impact in the critically ill.Intensive care medicine · 2025Review
- Dual concomitant CytoSorb hemoadsorption therapy in severe rhabdomyolysis: A novel approach to myoglobin clearance and organ preservation.The International journal of artificial organs · 2025Article
- Extracorporeal myoglobin elimination using the adsorber CytoSorb or the high-flux HF80 dialyzer for patients with severe rhabdomyolysis: a comparative study.Clinical kidney journal · 2025Article
- Hemoadsorption combined with continuous venovenous hemodialyfiltration in a patient withThe Journal of international medical research · 2025Article
- Rhabdomyolysis in intensive care unit-distinctive clinical indicators and prognosis.BMC anesthesiology · 2025Article
- Efficacy of haemoadsorption combined with continuous renal replacement therapy in patients with rhabdomyolysis and acute kidney injury: a retrospective study.Clinical kidney journal · 2025Article
- The use of CytoSorb hemoadsorption in critically ill patients: a narrative review.Frontiers in medicine · 2025Review
- Fulminant Red Yeast Rice-Associated Rhabdomyolysis with Acute Liver Injury and Hyperkalemia Treated with Extracorporeal Blood Purification Using CytoSorb.Drug, healthcare and patient safety · 2025Article
- Extracorporeal Elimination of Pro- and Anti-inflammatory Modulators by the Cytokine Adsorber CytoSorbInfectious diseases and therapy · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRhabdomyolysis is a serious condition that can lead to acute kidney injury with the need of renal replacement therapy (RRT). The cytokine adsorber Cytosorb® (CS) can be used for extracorporeal myoglobin elimination in patients with rhabdomyolysis. However, data on adsorption capacity and saturation kinetics are still missing.
methodsThe prospective Cyto-SOLVE study (NCT04913298) included 20 intensive care unit patients with severe rhabdomyolysis (plasma myoglobin > 5000 ng/ml), RRT due to acute kidney injury and the use of CS for myoglobin elimination. Myoglobin and creatine kinase (CK) were measured in the patient´s blood and pre- and post-CS at defined time points (ten minutes, one, three, six, and twelve hours after initiation). We calculated Relative Change (RC, %) with: [Formula: see text]. Myoglobin plasma clearances (ml/min) were calculated with: [Formula: see text]
resultsThere was a significant decrease of the myoglobin plasma concentration six hours after installation of CS (median (IQR) 56,894 ng/ml (11,544; 102,737 ng/ml) vs. 40,125 ng/ml (7879; 75,638 ng/ml) (p < 0.001). No significant change was observed after twelve hours. Significant extracorporeal adsorption of myoglobin can be seen at all time points (p < 0.05) (ten minutes, one, three, six, and twelve hours after initiation). The median (IQR) RC of myoglobin at the above-mentioned time points was - 79.2% (-85.1; -47.1%), -34.7% (-42.7;-18.4%), -16.1% (-22.1; -9.4%), -8.3% (-7.5; -1.3%), and - 3.9% (-3.9; -1.3%), respectively. The median myoglobin plasma clearance ten minutes after starting CS treatment was 64.0 ml/min (58.6; 73.5 ml/min), decreasing rapidly to 29.1 ml/min (26.5; 36.1 ml/min), 16.1 ml/min (11.9; 22.5 ml/min), 7.9 ml/min (5.5; 12.5 ml/min), and 3.7 ml/min (2.4; 6.4 ml/min) after one, three, six, and twelve hours, respectively.
conclusionThe Cytosorb® adsorber effectively eliminates myoglobin. However, the adsorption capacity decreased rapidly after about three hours, resulting in reduced effectiveness. Early change of the adsorber in patients with severe rhabdomyolysis might increase the efficacy. The clinical benefit should be investigated in further clinical trials.
trial registrationClinicalTrials.gov NCT04913298. Registered 07 May 2021, https//clinicaltrials.gov/study/NCT04913298.
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