Interessenskonflikt. 1) Cytosorb Register Planung. 2) Studie Seraph Microbind: ExThera Medical. 3) Fan von Arbeitsgruppe PD Dr.
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1 Interessenskonflikt 1) Cytosorb Register Planung 2) Studie Seraph Microbind: ExThera Medical 3) Fan von Arbeitsgruppe PD Dr. David, MHH
2 Cytokinelimination bei Sepsis JanT Kielstein Braunschweig
3 Cytokinelimination bei Sepsis 1) Sepsis unmet medical need 2) Cytokine in der Sepsis 3) Adsorber 4) Alternative Technologien
4 Cytokinelimination bei Sepsis 1) Sepsis unmet medical need 2) Cytokine in der Sepsis 3) Adsorber 4) Alternative Technologien
5 Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock KUMAR et al. Crit Care Med. 34(6): , 2006
6 From: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) JAMA 315(8): , 2016 SEPSIS: life threatening organ dysfunction caused ba a dysregulated host respone to infection.
7 From: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) JAMA 315(8): , 2016 organ dysfunction: acute change in total SOFA Score >2 points consequent to infection.
8 From: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) JAMA 315(8): , 2016
9 From: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) JAMA 315(8): , 2016
10 Liste der FDA /EMA zugelassenen Medikamente zur Therapie der Sepsis
11 Cytokinelimination bei Sepsis 1) Sepsis unmet medical need 2) Cytokine in der Sepsis 3) Adsorber 4) Alternative Technologien
12 Extracorporeal therapies in non-renal disease: treatment of sepsis and the peak concentration hypothesis RONCO et al. Blood Purif 22(1):164-74, 2004 Excess pro- and anti-inflammatory mediators removed by continuous combined therapies Unselective high efficiency extracorporeal therapies might remove excess of pro- and anti-inflammatory mediators diminishing the amplified inflammatory response and the immunoparalisis induced by cell hyporesponsiveness
13 The prognostic value of concomitant assessment of NTproCNP, C-reactive protein, procalcitonin and inflammatory cytokines in septic patients. TOMASIUK et al. Crit Care 18(3): 440, 2014
14 Cytokinelimination bei Sepsis 1) Sepsis unmet medical need 2) Cytokine in der Sepsis 3) Adsorber 4) Alternative Technologien
15 Early use of polymyxin B hemoperfusion in patients with septic shock due to peritonitis: a multicenter randomized control trial (n=243) PAYEN et al. Intensive Care Med 41(6):975-84, 2015
16 Efficacy of polymyxin B-immobilized fiber hemoperfusion for patients with septic shock caused by Gram-negative bacillus infection SAITO et al. PLoS One 12(3):e , 2017
17 biocompatible, highly porous polymer bead designed to capture and adsorb cytokines (~10-50 kda)
18 Effect of extracorporeal cytokine removal on vascular barrier function in a septic shock patient DAVID et al. J Intensive Care 5:12, 2017
19 Effect of extracorporeal cytokine removal on vascular barrier function in a septic shock patient DAVID et al. J Intensive Care 5:12, 2017
20 Hemoadsorption by CytoSorb in septic patients: a case series (n=26) KOGELMANN et al. Critical Care 21(1):74, 2017
21 Hemoadsorption by CytoSorb in septic patients: a case series (n=26) KOGELMANN et al. Critical Care 21(1):74, 2017
22 Efficacy and cardiovascular tolerability of EDD in critically ill patients: a randomized controlled study KIELSTEIN et al. AJKD 43: , 2004 Norepinephrine dose at 0 h EDD CVVH μg/kg/min UF volume EDD L/12h CVVH L/24 h Norepinephrine dose at 12 h EDD CVVH μg/kg/min
23 Hemoadsorption by CytoSorb in septic patients: a case series (n=26) KOGELMANN et al. Critical Care 21(1):74, 2017
24 From: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) JAMA 315(8):
25 Effect of hemoadsorption during cardiopulmonary bypass surgery a blinded, randomized, controlled pilot study using a novel adsorbent (n=37) BERNARDI et al. Critical Care 20:96, 2016
26 Effect of hemoadsorption during cardiopulmonary bypass surgery a blinded, randomized, controlled pilot study using a novel adsorbent (n=37) BERNARDI et al. Critical Care 20:96, 2016
27 stay tuned
28 Cytokinelimination bei Sepsis 1) Sepsis unmet medical need 2) Cytokine in der Sepsis 3) Adsorber 4) Alternative Technologien
29 Plasma exchange SCHWARTZ et al. Journal of Clinical Apheresis 31: , 2016
30 Plasma exchange in treatment refractory septic shock : Presentation of a therapeutic add-on strategy DAVID et al. Med Klin Intensivmed Notfmed 112(1):42-46, 2017
31 Plasmapheresis in severe sepsis and septic shock: a prospective, randomised, controlled trial BUSUND et al. Intensive Care 28: , 2002
32 Plasmapheresis in severe sepsis and septic shock: a prospective, randomised, controlled trial BUSUND et al. Intensive Care 28: , 2002
33 Therapeutic Plasma Exchange Decreases Levels of Routinely Used Cardiac and Inflammatory Biomarkers TUTAREL et al. PLoS ONE 7(6): e38573, 2012
34 Effect of TPE on plasma levels and total removal of adipokines and inflammatory markers SCHMIDT et al. BMC Obesity 2:37, 2015
35
36 Therapeutic plasma exchange as rescue therapy in severe sepsis and septic shock: retrospective observational single-centre study of 23 patients HADEM et al. BMC Anesthesiol 7;14(1):24, 2014
37 Therapeutic plasma exchange as rescue therapy in severe sepsis and septic shock: retrospective observational single-centre study of 23 patients HADEM et al. BMC Anesthesiol 7;14(1):24, 2014
38 The prognostic value of ADAMTS13 deficiency in septic shock patients involves interleukin-6 and is not dependent on disseminated intravascular coagulation PEIGNE et al. Crit Care 18;17(6):R273, 2013
39 Randomized, prospective, multicenter, open-label, controlled, parallel-group trial investigating the efficacy of add-on plasmaexchange as an adjunctive strategy against septic shock with multiple organ dysfunction (EXCHANGE trial) PI: PD Dr. Sascha David Hannover Medical School, GERMANY
40 Safety and Performance Evaluation of the Seraph Microbind Affinity Blood Filter for Reducing Bacteremia in Patients on Hemodialysis
41
42 I will survive
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