EVALUATION OF THE Cytosorb   HEMOADSORPTIVE COLUMN IN A XXXX MODEL OF SEVERE SMOKE AND BURN INJURY.

@entity1707 @entity16318 @entity9404 @entity9927 @entity22134 @entity18029 @entity204 @entity14463 @entity130
INTRODUCTION: Host inflammatory response to any form of tissue injury, including burn, @entity130 , or shock has been well documented. After significant burns, cytokines can increase substantially within the first 24hours after injury and may contribute to subsequent organ failure. Hemoadsorption by cytokine-adsorbing columns may attenuate this maladaptive response thereby improving outcomes. The aim of this study was to investigate the feasibility, technical safety and efficacy of cytokine and myoglobin removal by early use of a cytokine absorbing column (CytoSorb) in a porcine model of @entity9927 and @entity130 . METHODS: Anesthetized female Yorkshire @entity1707 (n=15) were injured by wood bark @entity9927 and a 40% total body surface area deep burn and observed for 72hours or @entity204 . The animals were randomized to hemoadsorption treatment (n=9) or a sham group (n=6) before injury. A six hour hemoadsorption or sham session was performed on days one, two and three. Serum cytokines ( @entity16318 , @entity22134 , @entity9404 , @entity18029 , @entity14463 ) and myoglobin were measured systemically, locally in bronchoalveolar lavage fluid and also in circulating blood before and after the adsorbing column to evaluate single pass clearance by the device. RESULTS: Hemoadsorption caused significant removal of @entity16318 , @entity22134 , @entity18029 and myoglobin across the device mainly during the first run, ranging from 22% for @entity22134 to 29% for @entity16318 and 41% removal rates for myoglobin after 15min of treatment. Systemic cytokine or myoglobin serum concentrations did not change. CONCLUSION: In a porcine model of smoke and @entity130 , hemoadsorption using the CytoSorb cartridge did not result in significant systemic or pulmonary reductions in the measured cytokines or myoglobin despite efficient transmembrane reductions. Further investigations are needed to optimize the efficiency of mediator clearance to impact both circulating levels and clinically relevant outcomes.
