ArticleIntensive care medicine experimental2026
Exploratory dose modeling of hemoadsorption in pediatric septic shock.
Article in Intensive care medicine experimental, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundClinical outcomes of hemoadsorption (HA) in sepsis remain uncertain despite demonstrated biological efficacy in in vivo models. Persistent knowledge gaps concern both patient selection-now increasingly interpreted through biological phenotypes-and optimal device application. In recent years, this latter aspect has been conceptualized as "dose," yet HA dosing remains poorly defined and inconsistently applied across age groups. Interestingly, pediatric studies have reported more favorable outcomes than adult cohorts. We therefore investigated the concept of dose in pediatric septic shock to elucidate mechanistic determinants of treatment efficacy.
methodsWe retrospectively analyzed 25 children with septic shock treated with CytoSorb
resultsMedian ABP was 14.4 (9.7-21.6) L/kg, substantially exceeding previously reported adult thresholds. No linear association was observed between ABP and vasopressor reduction. IL-6 reduction was strongly associated with baseline cytokine concentration (R² = 0.79, 95%CI= [-1.08; -0.62], p < 0.001), while ABP was not independently predictive.
conclusionsIn this exploratory pediatric cohort, hemoadsorption during CRRT was associated with high blood-purified-per-kilogram exposure and marked cytokine reduction. These findings suggest that, beyond a certain exposure level, mediator removal may become predominantly concentration-driven rather than dose-limited, supporting further investigation of dosing strategies based on inflammatory burden.
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