Use of CytoSorb hemoadsorption in a patient with sepsis and acute kidney injury: A case report

Abstract

Introduction. Continuous renal replacement therapy is one of the methods that proved to be successful in the treatment of sepsis and its complications such as acute kidney injury. One of the adsorbers tested is CytoSorb, which contains polystyrene-divinylbenzene pores with a biocompatible polyvinylpyrrolidone coating and that is also a highly adsorptive and biocompatible filter that facilitates selective removal of medium molecular weight molecules (10 - 15 kDa). Case Report. A 51-year-old male patient was hospitalized at the Department of Anesthesia, Resuscitation and Intensive Care due to multiple traumas caused by a fall from the third floor. After admission, laboratory and diagnostic methods were performed, the injuries were surgically treated and the patient received infusion, antibiotic and preventive anti-ulcer therapy along with measures of intensive treatment and monitoring of vital parameters. Progression of the pulmonary lesions, prolonged refractory hypotension unresponsive to therapeutic protocols, predisposed the onset of acute renal impairment and continuous venovenous hemodialysis with CytoSorb was applied. The procedure lasted 21 hours and 39 minutes, during which the urine output increased, and the need for vasoactive support was significantly reduced, while the lactate levels declined. Upon completion of the procedure, hemodynamic stability was achieved, with gradual improvement of consciousness, regression of pulmonary changes and reduction of inflammatory parameters and parameters of renal function. Conclusion. We can say that control of the patient?s hyperinflammatory response was the key factor in achieving stabilization of the patient, as well as organ recovery and survival. Future research should provide additional information on the contribution of CytoSorb in the treatment of patients with sepsis.