Cytosorbents (NASDAQ:CTSO), an immunotherapy developer, reported that strategic partner Fresenius Medical Care (FMS) is initiating sales efforts for its flagship product, the CytoSorb blood purification cartridge, in France, Poland, Sweden, Denmark, Finland, and Norway. Cytosorbents said Fresenius, a German healthcare company, has deployed a team of sales, marketing, and medical experts to work with nationally recognized key opinion leaders, to market CytoSorb at intensive care conferences and symposiums, and to promote CytoSorb to customers in the field.
Dr. Phillip Chan, Cytosorbents CEO, said: “Our collaboration with FMC has been excellent to date. We have been particularly impressed by the effort of their people and attention to detail that they have brought to the partnership. With their large installed base of dialysis machines, ability to rapidly access Intensive Care Units physicians, and the high quality of their marketing and sales organization, we believe FMC has set the stage for a strong CytoSorb market launch and potential future expansion.” The CytoSorb cartridge is designed to reduce the “cytokine storm” or “cytokine release syndrome” that could otherwise cause massive inflammation, organ failure and death in common critical illnesses such as sepsis, burn injury, trauma, lung injury, and pancreatitis, as well as in cancer immunotherapy.
The stock is down 0.47% or $0.02 after the news, hitting $4.27 per share. About 11,853 shares traded hands. Cytosorbents Corp (NASDAQ:CTSO) has declined 29.32% since October 23, 2015 and is downtrending. It has underperformed by 30.38% the S&P500.
CytoSorbents Corporation, a critical care focused immunotherapy company, engages in the research, development, and commercialization of medical devices with its platform blood purification technology incorporating a proprietary adsorbent polymer technology. Its principal product is CytoSorb device, an extracorporeal cytokine filter designed for the adjunctive therapy in the treatment of sepsis; for the adjunctive therapy in other critical care applications; the prevention of post-operative complications of cardiopulmonary bypass surgery and damage to organs donated by brain-dead donors prior to organ harvest; the treatment of cancer cachexia; the prevention of transfusion reactions caused by contaminants in transfused blood products; and the prevention of contrast induced nephropathy, the treatment of drug overdose, and the treatment of chronic kidney failure.
The company is also developing HemoDefend blood purification technology platform to reduce contaminants in the blood supply that can cause transfusion reactions or disease when administering blood and blood products to patients; and ContrastSorb for the removal of IV contrast in blood administered during CT imaging, an angiogram, or during a vascular interventional radiology procedure to reduce the risk of contrast-induced nephropathy. In addition, it is developing BetaSorb device for the prevention and treatment of health complications caused by the accumulation of metabolic toxins in patients with chronic renal failure; and DrugSorb, an extracorporeal hemoperfusion cartridge designed to remove toxic chemicals from the blood. The company was formerly known as MedaSorb Technologies Corporation and changed its name to CytoSorbents Corporation in May 2010. CytoSorbents Corporation was founded in 1997 and is based in Monmouth Junction, New Jersey.
First description of single-pass albumin dialysis combined with cytokine adsorption in liver failure and hemophagocytic syndrome resulting from generalized herpes simplex virus 1 infection
Frimmel S, Schipper J, Henschel J, Tsui TY, Mitzner SR, Koball S. Division of Nephrology, Department of Medicine, Rostock University Medical Center, Rostock, Germany
This case study reports on a 50-year-old immunocompetent woman who was admitted to hospital for acute hepatitis with acute liver failure.
Liver biopsy revealed acute liver cell necrosis due to herpes simplex virus type 1 (HSV-1)
Despite antiviral therapy liver failure progressed and patient was transferred to ICU
Rapid development of MOF with hepatic coma, severe coagulopathy, acute anuric renal failure, respiratory insufficiency and arterial hypotension
Patient was listed for highly urgent liver transplantation
Additional diagnosis of hemophagocytic lymphohistiocytosis (HLH), secondary to HSV-1-infection
Hemodialysis and extracorporeal liver support were initiated using MARS ® -therapy (6 hours 1 st day, 19 hours 2 nd day)
Increasing need for NE and excessively elevated concentrations of inflammatory markers indicated ongoing severe SIRS
Hence extracorporeal therapy was changed to CVVHD with SPAD (12 hours of treatment)
One session of CytoSorb treatment was performed with a treatment duration of 20 hours
CytoSorb was integrated in a predialyzer position
Regional anticoagulation was performed using sodium citrate
Need for vasopressors
IL-6 levels fell from 81059 pg/ml to 17177 pg/ml after 12 hours of treatment
Noradrenaline dosage was reduced to 0.25 µg/kg/min
No further clinical deterioration of the patient
Antiinfective therapy was conducted with Acyclovir, with no reported adaption of dosage during CytoSorb treatment
Reduction of the moderately elevated bilirubin with SPAD + CytoSorb
Successful OLT on 4th day on ICU
Further improvement after OLT
First report of the combined use of CytoSorb with SPAD in a patient suffering from ALF and probable HLH with severe SIRS listed for liver transplantation
Major results of the intervention were a marked decrease of IL-6, and bilirubin, as well as a reduction of vasopressor need
Treatment was safe and well-tolerated, without any adverse events
Existing liver support technique (MARS ® treatment) had no effect on the reduction of bilirubin
CytoSorb might be a useful tool for patients with acute liver failure and severe hyperinflammatory syndromes
Renal replacement therapy neutralizes elevated MIF levels in septic shock.
Pohl J1, Papathanasiou M1, Heisler M1, Stock P1, Kelm M2, Hendgen-Cotta UB1, Rassaf T1, Luedike P1.
1West-German Heart and Vascular Center Essen, Department of Cardiology and Department ofVascular Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany.
2Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, University Hospital Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany.
Macrophage migration inhibitory factor (MIF) is known to amplify the immune response in septic animal models. Few clinical data support this pro-inflammatory role in septic patients. Renal replacement therapy (RRT) as adjuvants in the complex therapy of sepsis has been proposed as a possible approach to eliminate elevated circulating cytokines. Since recent data suggest that MIF can be effectively removed from the circulating blood pool in patients with chronic kidney disease, we here aimed to investigate whether RRT in septic shock can lower plasma levels of this pro-inflammatory cytokine in septic shock patients.
An observational single-center study on an internist intensive care unit (ICU) was conducted. MIF plasma levels and mortality of n = 25 patients with septic shock were assessed with a previously validated method for reliable MIF values. The effect of continuous renal replacement therapy (CRRT) on daily MIF levels and mortality was assessed by comparing patients with and without need for CRRT due to acute kidney injury (AKI).
MIF plasma levels in patients undergoing CRRT due to septic AKI were steadily decreased compared to those from patients without CRRT hinting at a MIF removal by hemodialysis. MIF release during ICU stay as assessed by MIFAUC was lower in patients undergoing CRRT, and Kaplan-Meier analysis revealed a distinctly lower mortality in patients undergoing CRRT. Analysis of daily MIF levels showed that patients who did not survive septic shock exhibited steadily higher MIF plasma levels and higher MIFAUC compared to those surviving sepsis. Low MIF levels were closely associated with improved survival.
This is the first study investigating the effect of efficient MIF removal from the plasma pool of patients with septic shock. Reduction of high circulating MIF by CRRT therapy was accompanied by improved survival. Thus, targeted removal of MIF from the circulating blood pool might be a promising approach to reduce mortality in severe sepsis.
CytoSorb in septic shock after perforated Ulcus ventriculi
Dr. Markus Teipel, head physician, Interdisciplinary Intensive Care, Nordwest-Krankenhaus Sanderbusch GmbH
This case study reports on a 43-year-old male patient, who was transferred to hospital via emergency boat and ambulance service from Langeoog island with initially belt-shaped and then diffuse radiating acute pain in the upper abdomen, dark vomitus, diarrhea and dyspnea.
Diagnosis: perforated ulcus ventriculi at the small curvature
Immediate emergency laparoscopy and laparotomy within 2 hours after admission followed by surgical suturing and covering of the perforation
The patient was transferred to ICU intubated and ventilated
At this time the patient was hemodynamically unstable, hypotonic, tachycardic with high requirement for catecholamines (noradrenaline 0.5 ug / kg / min)
Significantly increased inflammatory parameters: PCT 200 ng/ml, leukocytes 6.900/µL, CRP 27 mg/dl
Advanced hemodynamic monitoring showed septic shock with high volume requirements (SVRI 1500 dyn*s*cm-5*m², ELWI 5.6 ml/kg, GEDI 496 ml/m²)
High loading volumes (positive fluid balance 12 liters) with poor and further decreasing spontaneous diuresis (200 ml/day), creatinine 5.8 mg/dl, GFR 11.3 ml/min, urea 95 mg/dl
Initiation of antibiotic therapy with ertapenem followed by additional calculated antifungal treatment with caspofungin
Hydrocortisone 200 mg/day, continuous Amiodarone with 300 mg loading dose (maintenance dose 900 mg/d)
Insertion of a Shaldon catheter and initiation of continuous veno-venous hemodiafiltration (CVVHDF)
Due to acute renal failure, sharp increase in inflammatory markers, progressive need for vasopressors and septic shock, CytoSorb was started 24 hours after initiation of CVVHDF
Two consecutive CytoSorb treatment sessions for 24 hours each
CytoSorb was used in conjunction with citrate dialysis (Prismaflex; Gambro) in CVVHDF mode
Blood flow rate: 150 ml/min
CytoSorb adsorber position: post-hemofilter
Demand for catecholamines
Advanced hemodynamic monitoring parameters (SVRI, GEDI)
Inflammatory parameters (PCT, CRP)
Renal function (excretion)
Clear stabilization of hemodynamics during the course of the two CytoSorb treatments (GEDI 840 ml/m², SVRI 2600 dyn*s*cm-5*m²)
With installation of the adsorber the norepinephrine dose could be reduced significantly to around 1/5 of the initial dose after completion of the first CytoSorb treatment and a further reduction to 0.08µg/kg/min after completion of the second treatment. Five days after the first treatment norepinephrine could be completely tapered off
Reduction of inflammatory parameters during the two treatments: PCT to 45 ng/ml after the first and to 23 ng/ml after the second treatment, CRP at 27 mg/dl after the first treatment and 7.4 mg/dl after the second treatment
Two days after completion of CytoSorb therapy increasing spontaneous diuresis
Antibiotic dosages did not have to be adjusted at any time
Cessation of renal replacement therapy 5 days after last CytoSorb treatment
Extubation on postoperative day 11
Antibiotic treatment with ertapenem could be discontinued 10 days and the antifungal treatment 14 days after admission
After extubation, patient had ongoing delirium which normalized over the next 4 days
No neuropathic sequelae
Transfer to IMC 16 days after initial admission and 4 days later to the normal ward
Clear stabilization and consolidation of hemodynamic and inflammatory mediators with CytoSorb within 48 hours
Conventional therapy using the sepsis bundle was not enough to hemodynamically stabilize the patient during his acute septic phase, however, after using the CytoSorb adsorber this could be achieved in a short period of time
The application of CytoSorb therapy was simple, safe with no problems installing the adsorber in a post-hemofilter position
During his life, Muhammad Ali did many great things for a great many people. But he may still have another contribution to make to the public, or in this case, for the public’s health.
The cause of Ali’s death has been given as septic shock, not from Parkinson’s Disease, the condition that had stalked him the last 30 years of his life.
Sepsis is one of the deadliest killers of Americans. More people die of sepsis in the U.S. every year than AIDS, breast cancer and colon cancer combined. According to a federal study, it’s also the most expensive cause for hospitalizations in the U.S.
Sepsis can occur in anyone with a weakened immune system when a pathogen, either a fungus or bacteria, enters the bloodstream and sends the body’s major organs into shock. This could happen through a cut in the skin, an internal rupture of an organ or even through a patient’s PIC line in the hospital. Unable to fend off the infection, the pathogen overwhelms the blood, and the patient’s organs begin to basically shut down.
Sepsis spreads very rapidly through the body, so it is critical to identify the cause in a patient, whether fungal or bacterial, and administer the appropriate response before the sepsis is completely out of control for any chance of saving the patient.
Every hour of delay of the correct treatment increases mortality by 8%.
When patients present with sepsis, most physicians’ first move is to prescribe a broad spectrum of antibiotics while the patient’s blood culture test is processed, which could take one to five days. But if the sepsis is not caused by bacteria, the antibiotic treatment is utterly useless, and wastes precious hours as the infection rages on.
And, because giving an antifungal at the same time as an antibacterial could be toxic for the patient, the physician will have to wait hours, maybe days, before administering an antifungal drug.
Meanwhile you’ve just given a sick patient powerful antibiotics needlessly, increasing the potential for future resistance against a true bacterial infection.
According to the CDC, over one million Americans will be affected by sepsis, and 1.6 million will be hospitalized with the condition. Sepsis claims 258,000 lives each year. Nearly one third to one half of all hospital deaths in the U.S. are related to sepsis. There is evidence that more and more American lives are being claimed by sepsis each year. In fact, you are more likely to die of sepsis in America than you are to even encounter Ebola, Zika, West Nile virus, malaria or dengue fever combined.
The technology most hospitals rely on in their pathology labs to run blood culture tests are close to 90 years old and can take days to process. However, some hospitals are already beginning to utilize newer, faster technology like a platform device called the T2Dx.
Made by T2 Biosystems, Inc., the T2Dx is an FDA-cleared device that can rapidly detect and identify a blood infection in three to five hours, with rapid pinpoint screening of fungus-caused infections. That’s important because approximately 15% of healthcare-associated infections are caused by fungi, and 70-90% of all those infections are due to a family of fungus called Candida, which the T2 Biosystems device tests for. Eventually, T2’s device should be cleared to discern between various types of infections, including a test for detecting sepsis due to a bacterial infection.
American healthcare leadership is focused on the rise of drug-resistant bacteria and the ineffectiveness of antibiotics; antifungal medications have also been losing their potency. Later today, in fact, the U.S. Congressional Committee of Energy and Commerce is holding a hearing on the issue of combating drug resistance. They should also be asking about the increasing weakness of standard anti-fungal infection medications, which are also becoming more vulnerable to superbugs.
We have helped create superbugs because we misidentify infections and grossly misuse antibiotics and antifungals. Given the number of infections per year and the amount of drugs prescribed wantonly to treat patients, it is essential that the guesswork be taken out of the process of treating infections that cause sepsis. While there are several efforts to develop novel antibiotic and antifungal drugs, we still need to place better diagnostics in our hospitals to use our current arsenal accurately and wisely.
When patients receive the correct treatment quickly, they stand a better chance to survive and receive further treatment through the healthcare continuum. The benefits to the patient are obvious, but it also benefits all players in the market, including pharmaceutical giants like Merck and Pfizer, two of the largest manufacturers of antifungals and antibiotics.
The right drug utilized at the right time also means that there is less chance of exposing pathogens needlessly to critical drugs, thereby potentially decreasing their potency. Today, entire classes of antibiotic and antifungal drugs are losing their effectiveness because of their overuse in both humans and animals in the livestock industry.
What makes this striking is the fact that many of the major pharmaceutical companies have abandoned antibiotic and antifungal R&D.
After WWII, Pfizer was the established leader in antibiotic drug development, having provided penicillin for our troops. While Pfizer still makes several important antibiotic drugs, the company shut down its gram-negative antibiotic drug development campus in 2011. Sanofi, Eli Lilly and Bristol-Myers Squibb haven’t conducted significant R&D on antibiotics since the 90s. Instead, big pharma has focused resources on newer areas of medicine like immunotherapy (just as they did in the 1940s with antibiotics), along with other mainstays like statins, antidepressants and newer autoimmune/anti-inflammatory drugs. Antibiotics and antifungals are not as appealing financially, nor are they treatments for chronic diseases. For Big Pharma, that means an unsteady stream of income, and so most large drugmakers have bailed on those drug classes.
Today, smaller biotech companies are the major players aggressively developing newer antibiotics and antifungal medications.
When Muhammad Ali entered the hospital two weeks ago, the reported cause was respiratory problems. Within a couple days, he was gone; cause, septic shock.
We will probably never know what caused Muhummad Ali’s sepsis–or when it set in–but his death has brought momentary attention long overdue to an illness that has reached epidemic proportions in the U.S. Anyone who has seen a loved one suffer through septic shock knows how sudden and dreadful it can be.
Once it takes hold, sepsis can be very difficult to reverse, making it even more important to utilize the best technologies modern science can provide. In the future, that may include a combination of rapid-fire diagnostics like T2’s device and more conventional blood culture studies for a fuller view of the patient’s condition.
Hopefully during today’s congressional hearing, the panel will enter the ring and cover the broader issues we face with superbugs, and realize that part of dealing with this issue is to for the government to encourage adoption of modernized diagnostic technologies, and for hospitals to embrace them to better meet the needs of their patients.
05-25-2016 4 Current version
10-22-2015 3 Update
01-28-2014 2 Update
07-17-2013 1 First version
Recruitment Status: Recruiting complete, follow-up complete
Study Closing (LPLV): 2015/12/31
Great interest in CytoSorb at the Euroelso Congress 2016 in Glasgow - from left to right Dominik Gutzler, Stefan Baudis, Prof. Robert Bartlett
Dominik Gutzler -Great to see that CytoSorb is in the mind of many experts. Synergetic effects are seen on base of the current experiences. Traffic at our booth was high over the whole conference.
Around 160 interested people attended the symposium "CytoSorb® – Neues zur Therapie von Sepsis und schwerem SIRS" at the annual meeting of the German and Austrian intensive care medical societies that now takes place in Berlin. Prof Kluge from Hamburg talked about "Sepsis 3.0 – Was gibt es Neues? (Sepsis 3.0-what's new?) and Dr Friesecke from Greifswald presented new promising data.
Three-time world heavyweight boxing champion Muhammad Ali died of septic shock "due to unspecified natural causes," a family spokesperson told reporters on Saturday.
He was hospitalized last Monday with respiratory issues. Ali was 74.
According to the Centers for Disease Control and Prevention, sepsis is the body's overwhelming response to an infection. It can lead to tissue damage, organ failure, and death.
"If you have a splinter in your hand, you get a local inflammatory response. You get inflammation and pus, but you don't get sick. Now, say you get a big infection, you have that same local response, but then you also have a whole body response," Dr. Fredrick Moore, chief of acute care surgery at University of Florida Health and Director of the UF Sepsis and Critical Illness Research Center, explained to CBS News.
The CDC reports there are over 1 million cases of sepsis each year in the U.S. It kills more than 258,000 Americans annually, making it the ninth leading cause of disease-related deaths.
If caught early, sepsis can be treatable with fluids and antibiotics. But it progresses quickly and if not treated, a patient's condition can deteriorate at a rapid pace. Septic shock occurs when someone has all of these symptoms plus extremely low blood pressure that doesn't respond to fluid replacement.
Anyone can get sepsis as a reaction to an infection, but the risk is higher in older adults, babies and very young children, and people with weakened immune systems.
Ali's daughter Hana described her father's last moments in a tweet. She said that although all of his organs had failed in the end, "his heart would not stop beating."
"For 30 minutes... his heart just kept beating," she wrote. "No one had ever seen anything like it. A true testament to the strength of his spirit and will."
Taipei, June 6 (CNA) A Taiwanese research team has discovered a molecule in human cells that can regulate inflammation when infections caused by invasive pathogenic germs occur and help protect the body from systemic inflammation, known as sepsis.
Every year, about 110,000 patients in Taiwan die from sepsis triggered by terminal cancer or surgical inflections, said Kuo Cheng-chin (郭呈欽), an associate researcher at the Institute of Cellular and System Medicine under the National Health Research Institutes (NHRI), when presenting the findings on Monday.
Kuo said patients become weaker after undergoing an operation or chemotherapy and are particularly vulnerable at those times to pathogenic germs that invade patients' circulation systems and reproduce in big quantities.
The germs can trigger acute infections throughout the body, causing systemic inflammation that can induce multi-organ failure.
There is currently no drug that can protect patients against the phenomenon, Kuo added, but the team's research may offer a path to a solution.
The research team Kuo worked with spent three years studying endothelium, which plays a critical role in maintaining cellular and inflammatory balance and controlling systemic inflammation and the progress of inflammatory diseases, Kuo said.
Endothelium is the tissue which forms a single layer of cells lining various organs and cavities of the body, especially the blood vessels, heart and lymphatic vessels.
During the study, the team found that endothelium produces and releases a defending molecule, called 5-methoxytryptophan (5-MTP), that acts to restrain inflammatory responses in the body, Kuo said.
During laboratory trials, they found the molecule increased the survival rate of sepsis-affected mice by 80 percent, he said.
The 5-MPT molecule can be acquired through the process of chemical synthesis at a small cost of several hundred Taiwan dollars, according to Kuo.
"It's fairly cheap," he said, noting that if the technology is successfully transferred and commercialized, a drug for sepsis could be developed and produced in five years. Patents for the process are now being applied for in many countries, he said.
The study has been published in international journal "Circulation Research" in May.
Members of the research team include Kuo, former NHRI President Kenneth Wu (伍焜玉) and two physicians at Tri-Service General Hospital, Hsu Yu-juei (許育瑞) and Yang Ya-sung (楊雅頌).
CytoSorb in pneumogenic septic shock after mitral valve reconstruction
Dr. Bastian Huschens, Dr. Ender Demircioglu, Department of Thoracic and Cardiovascular Surgery, University Hospital Essen
This case study reports on a 45-year-old female patient with mitral valve regurgitation III° and tricuspid valve regurgitation I-II° who underwent elective mitral valve reconstruction and then gradually deteriorated during her postoperative intensive care course.
On the 3rd postoperative day (POD) development of a ventilator-associated pneumonia culminating in pneumogenic sepsis with accompanying ARDS
Increased plasma levels of inflammatory parameters: PCT 29.4 ng/ml, CRP 21.2 mg/dl, elevated lactate 6.1 mmol/l
Antibiotic regimen: ciprofloxazin, tazobactam/piperacillin
Septic shock with multiple organ failure: hemodynamics (norepinephrine dose on the 2nd POD 1.5 µg/kg/min), lung, kidney, liver
Development of sepsis-associated liver dysfunction (bilirubin 3.9 mg/dl on the 1st POD and further increasing levels with a peak value on the 6th POD of 20 mg/dl)
Further deterioration of renal function, initially oliguric but trending towards decreasing excretion culminating in anuria and initiation of continuous renal replacement therapy (CVVH) on POD 5
Pre-ECMO therapy: kinetic positioning for 4 days
Initial stabilization of the circulatory situation (epinephrine dose on the 7th POD 0.05 µg/kg/min)
Second septic insult along with hemodynamic deterioration on POD 8 with 0.2 µg/kg/min and worsening liver failure (plasma bilirubin levels with peak value of 38.5 mg/dl, quick 24%, hepatic encephalopathy), lactate at 3.1 mmol/l
Escalation of antibiotic therapy from ciprofloxazin, tazobactam/piperacillin to imipenem/cilastatin
Due to acute renal- and respiratory failure, sharp increase in inflammatory markers and progressive need for vasopressors as well as further increase in bilirubin levels indicative of progressive liver failure, CytoSorb was installed into the CVVH circuit on the 8th POD
8 CytoSorb treatment sessions for 24 hours each and a total treatment period of 8 days
CytoSorb was used in conjunction with citrate dialysis (Multifiltrate; Fresenius Medical Care) in CVVHDF mode
Blood flow rate: 100 ml/min
Anticoagulation: initially heparin, after recovery of liver function change to citrate
CytoSorb adsorber position: pre-hemofilter
Demand for catecholamines
Inflammatory parameters (PCT, CRP)
Renal function (excretion)
After implementation of CytoSorb there was an initial deterioration of the hemodynamic situation with increasing needs for catecholamines from 0.2 to 0.6 µg/kg/min for the first 24 hours, however there was a significant stabilization of hemodynamics in the further course of combined CVVH-CytoSorb treatment with a clear reduction in norepinephrine requirements. After 48 hours norepinephrine could be significantly reduced and was completely tapered off on the 12th POD
Reduction of inflammatory parameters during the course of treatments: PCT from 43.5 ng/ml on the first treatment day to 7.42 ng/ml on the 2nd and 1.35 ng/ml on the last treatment day; CRP from 31.8 mg/dl on the first treatment day to 21.3 mg/dl on the 2nd and 14.7 mg/dl on the last treatment day
Lactate from 1.3 mmol/l on the first treatment day to 4.6 mmol/l on the 2nd and 2.0 mmol/l on the last treatment day
Bilirubin from 25.6 mg/dl on the first treatment day to 17.2 mg/dl on the 2nd and 4.7 mg/dl on the last treatment day
Ammonia from 64 µg/dl on the first treatment day to 55 µg/dl on the 2nd, 135 µg/dl on the 4th, 201 µg/dl on the 5th and 6th treatment day and 47 µg/dl after the last treatment
No recovery of renal function
Patient still dialysis-dependent on POD 24
Regressive hepatic encephalopathy along with significant neurological improvement (vigilance)
Patient is free of catecholamines, complete regeneration of liver function including stabilization of coagulation disorder even without substitution
CPAP without pressure support, alternated with nightly BiPAP training
Transfer of the patient to a weaning clinic while awake, oriented and hemodynamically stable
The most obvious effect was the significant and rapid stabilization of liver function and neurological improvement
Acute phase of septic shock could be overcome surprisingly quickly
Clear stabilization and consolidation of hemodynamics and inflammatory mediators with CytoSorb
Handling of the adsorber was easy and safe
We had about 10 investors last year. All total about 20-25 ,Dr Steiner will be at the meeting.plus board members and management. Where you coming from. I am from CT. They will be servicing Coffee an.
I have been to other Annual meetings. Try to get there early 9:30.
Any other info needed email me at email@example.com
12:00 to 13:00 | room 2
CytoSorb® - New for the treatment of sepsis and severe SIRS
Presidency S. Kluge, Hamburg
Sepsis 3.0 - What's new? P Kluge, Hamburg
CytoSorb® in septic shock - Presentation of study data from Greifswald S. Friesecke, Greifswald
Cancer cell therapies could be approved next year: Juno, Kite Pharma
CHICAGO (Reuters) - A new wave of experimental cancer drugs that directly recruit the immune system's powerful T cells could begin reaching patients next year, according to companies presenting new data at the annual meeting of the American Society of Clinical Oncology.
In interviews with Reuters, Kite Pharma Inc and Juno Therapeutics Inc both said they could receive initial regulatory approvals next year for a type of immunotherapy treatment known as chimeric antigen receptor T-cell (CAR-T) therapies.
CAR-T therapies involve a complicated process of extracting immune system T cells from an individual patient, altering their DNA to sharpen their ability to spot and kill cancer cells, and infusing them back into the same patient.
The technique is being tested against a range of different cancer types, but first in blood cancers. Kite aims to file this year for U.S. Food and Drug Administration approval of its therapy, KTE-C19, for patients with diffuse large B-cell lymphoma (DLBCL), according to Chief Medical Officer David Chang.
Juno Chief Executive Officer Hans Bishop said adult patients with acute lymphoblastic leukemia (ALL) are now being enrolled in a mid-stage trial of the company's most advanced product, JCAR015, that "we believe will support accelerated approval." He said JCAR015 "could be approved as soon as 2017."
Data presented on Saturday showed that 77 percent of patients with advanced ALL achieved a "complete response," meaning cancer remission, when treated with chemotherapy followed by Juno's cell therapy. For the trial patients with minimal disease, 90 percent achieved remission, researchers said.
Twenty-seven percent of patients in the JCAR15 trial experienced a severe inflammatory response to the altered cells, and 15 percent had serious nervous system side effects.
Bishop said Juno has developed an assay to determine which patients are likely to experience risky side effects, but said the company has not yet disclosed the details.
A separate National Institutes of Health early-stage study involving Kite's CAR-T drug and low-dose chemotherapy included 19 patients with various subtypes of DLBCL. Of those, eight patients achieved remission, five had partial responses, two had stable disease, and four had their cancer get worse. Two trial patients with advanced follicular lymphoma also obtained remissions.
"In the near future, CAR-T cells will likely be a standard therapy for lymphoma," said lead study author James Kochenderfer, an investigator at the National Cancer Institute.
Some patients treated with the still-experimental therapies have remained cancer free, but the jury is out on whether that will continue, or whether they will need new treatment.
"Some of these responses are amazing in patients who would never have responded to anything," said ASCO President Dr Julie Vose. "The question is, is it practical? We are now seeing results for more patients, and longer follow up."
Juno's Bishop said he is certain that the benefit of CAR-T therapies will be shown to outweigh any risks.
"These are patients that are relapsed and refractory. They are going to die of their disease," he said. "We can get 90 to 100 percent of them into remission, and a meaningful percentage of them have durable remission."
Renowned boxer Muhammad Ali died from septic shock due to natural causes Friday night, his family announced Saturday, while inviting fans to a public funeral that Ali had requested years before he died.
His family had been called to his bedside at a hospital in Phoenix, Ariz., on Friday, when what began as a respiratory problem became a dire situation, spokesman Bob Gunnell said at a press conference near the facility.
In the minutes leading up to his death, Ali, who suffered from Parkinson’s syndrome, was surrounded by his daughters, son and wife who were holding his hands, hugging him, chanting the Islamic prayer and saying, “You can go now. We will be OK,” according to his daughter, Hana Ali.
She said his heart continued to beat after all his other organs had failed. “A true testament
Save the date: on 29. November 2016 will take place the next german cytosorb user meeting in Hamburg (right before the beginning of the divi Congress). The exact program will shortly be published here:
Example: Last November, after acquiring the debt-laden Wise Metals Group, aluminum manufacturer Constellium, formerly known as Alcan, told analysts that all options–including abandoning the unit–were on the table. Then on Dec. 9 it announced it was trying to refinance Wise’s $900 million in debt in a deal that wouldn’t be guaranteed by Constellium, fueling fears that it might allow Wise to slip into bankruptcy.
End of story? Nope. Reorg’s staff combed through SEC filings and bond indentures and reported on Dec. 11 that Constellium, a Dutch company once controlled by Apollo GlobalManagement and Rio Tinto , would be considered in default on its own debt if it put Wise into bankruptcy. Since then, Wise senior bonds, rather than tanking, have gained $70 million in value, as investors called Constellium management’s bluff.
Case report of a patient with multiorgan failure due to severe SIRS in cardiac failure additionally treated with CytoSorbents haemadsorption as an adjunctive therapy
Klaus Kogelmann, Matthias Drüner, Dominik Jarczak, Department of Anaesthesiology and Intensive Care Medicine, Hospital Emden
This case study reports on a female patient who was admitted to hospital after she collapsed several times at home
Patients medical history included peripheral arterial obstructive disease, arterial hypertension and a previous minor stroke
Glasgow Coma scale was 11, heart rate 20 bpm, hypothermia 30 °C, metabolic acidosis with pH 7.2, no measurable blood pressure
After immediate resuscitation the patient developed severe SIRS and multiple organ failure with cardiogenic shock due to refractory cardiac arrhythmia • Initial ultrasound of heart function showed diffuse hypokinesia and an ejection fraction (EF) of around 45 %, with a heart rate of 36 bpm
24 hours of conventional treatment (differentiated catecholamine therapy with combined norepinephrine and adrenaline, ultrasound guided volume therapy, lung-protective ventilation, temporary cardiac pacemaker)
Following this, ultrasound showed diffuse dysfunction and hypokinesia with an EF of 50 %
Laboratory tests and electrocardiography on admission showed neither myocardial infarction nor evidence of infection but highly elevated liver enzymes and creatinine
Due to high and stable catecholamine support associated with persistent renal failure, CytoSorb therapy and CRRT were initiated
Duration of therapy with CytoSorb was 72 hours
Three CytoSorb treatment sessions for 24 hours each
CytoSorb was used in conjunction with citrate dialysis (Multifiltrate; Fresenius Medical Care) in CVVHD mode
Blood flow rate: 100 ml/min
CytoSorb adsorber position: pre-hemofilter
Before, during and after treatment
o SAPS II-Score, SOFA-Score
o Mean Arterial Pressure
o Requirement for norepinephrine
o Blood lactate level
o Demand of norepinephrine (µg/h vs. mmHg MAP)
During CytoSorb therapy the authors observed a decrease in catecholamine demand of more than 95 %, and 72 h after therapy the patient was free of catecholamines
SOFA Score did not change; SAPS II-Score decreased to 50 % of its initial value
Blood lactate decreased from 46.9 to 21.4 mg/dl
Liver function tests improved, AST decreased from 5355 U/L to 431 U/L 3 days later; ALT decreased from 4858 U/L to 888 U/L and LDH decreased from 6859 to 242 U/L
12 days after treatment the liver enzymes had returned to normal values
Chest X-ray 10 days after admission showed only slight effusions, 6 days later she could be weaned from ventilation, the patient was alert, vigilant and stable clinically without the requirement for catecholamines
During therapy, blood natriuretic peptide level showed a tenfold increase to 1.959 pg/ml as a marker of left ventricular dysfunction
Coronary angiography showed three vessel coronary artery disease with ischemic cardiomyopathy as the reason for the patients cardiac arrhythmia which had led to pump failure and the severe SIRS
Treatment using CytoSorb adsorption in this patient with severe cardiac failure due to ischemic cardiomyopathy was associated with significant clinical improvement, was safe and without apparent side effects
The authors note that CytoSorb therapy was helpful even in a patient with marked cardiac failure leading to severe SIRS