#4107 THE ROLE OF CYTOKINE ADSORBER IN REDUCTION INTERLEUKIN-6 LEVELS: A MATCHED CASE-CONTROL SINGLE CENTER ANALYSIS

Abstract

Abstract Background and Aims Extracorporeal cytokine adsorption is used with the aim to reduce pathogenic levels of cytokines in critically ill patients. Although technically and theoretically plausible, little convincing data exist to support wide use of cytokine adsorber in clinical practice. We aimed to retrospectively compare the time course of interleukin-6 (IL-6) in patients treated with or without the adsorber (CytoSorb®). Method In this retrospective, case-control study all patients treated between Jan 2017 and Dec 2021 in a medical ICU were screened and included, if at least two IL-6 measurements were available. Patients were divided to adsorber group and standard of care group based on the treatment received. Unmatched and matched groups were compared regarding IL-6, lactate, CRP, procalcitonin, and vasopressor demand at predefined time points. Mortality rates were also compared. Results We screened 3865 patients and included 52 patients in the adsorber group and 94 patients in the standard of care group. After matching, there were 21 patients in each group. Patients had similar age (53 (41, 68) vs. 61 (56, 67) years), ECMO was used in 24% (both groups) and renal replacement therapy in 100% of patients (both groups), baseline noradrenaline requirement (0.04 vs. 0.03 mg/kg/h), serum lactate (6.8 vs. 5.4 mmol/l), pH (7.27 vs. 7.21), CRP (182 vs 167 mg/l), and IL-6 (2441 vs. 2552 ng/l) were comparable between adsorber group and SOC group. There were no significant differences in the time course of IL-6, lactate, CRP, procalcitonin, and noradrenaline requirement between the groups. Two-day (33% vs. 28%) and ICU (57% vs. 62%) mortality and Kaplan-Meier survival curves (log-rank p = 0.9) were comparable. Conclusion In our matched case-control study, no difference in IL-6 or inflammatory parameters reduction, noradrenaline demand, or mortality was observed between patients, treated with adsorber (CytoSorb) or standard of care.