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andy55q 61 posts  |  Last Activity: 14 hours ago Member since: Feb 2, 2006
  • Reply to

    Cytosorb Combined With CRRT In Cardiac Surgery

    by berthabluefish May 24, 2016 11:05 AM

    Treatment of post-cardiopulmonary bypass SIRS by hemoadsorption: a case series.
    Träger K1, Fritzler D1, Fischer G1, Schröder J1, Skrabal C2, Liebold A2, Reinelt H1.
    Author information
    1Department of Cardiac Anesthesiology, University Hospital Ulm, Ulm - Germany.
    2Clinic of Cardiothoracic and Vascular Surgery, University Hospital Ulm, Ulm - Germany.
    Abstract
    The use of cardiopulmonary bypass (CPB) in cardiothoracic surgery results in a well-known activation of the immunologic response. In some cases, however, this triggered immunologic response may be excessive, leading to a severe systemic inflammatory response syndrome (SIRS) and induced organ dysfunction. For example, patients frequently develop hemodynamic instability with hypotension and low systemic vascular resistance. To date, different therapeutic approaches, such as steroids, have been tried to control this maladaptive postoperative SIRS response, yet definitive proof of clinical efficacy is missing. A new cytokine adsorber device (CytoSorb; CytoSorbents) may be a useful approach to control hyperinflammatory systemic reactions by reducing a broad range of proinflammatory cytokines and other inflammatory mediators. This may, in turn, help to reestablish a physiologic immune response and help to restore deranged clinical parameters in these patients. In this retrospective case series study, we describe 16 cardiac surgery patients following prolonged CPB with post-CPB SIRS and subsequent acute kidney injury, who were then treated with hemoadsorption using CytoSorb in combination with continuous renal replacement therapy (CRRT). Treatment of patients with CytoSorb who presented with severe post-CPB SIRS resulted in a reduction of elevated cytokine levels, which was associated with a clear stabilization of deranged hemodynamic, metabolic, and organ function parameters. Treatment was well tolerated and safe, with no device-related adverse events occurring. CytoSorb therapy combined with CRRT is a potentially promising new treatment approach to achieve hemodynamic stability, cytokine reduction, and improved organ function in cardiac surgery patients who develop post-CPB SIRS.

    Sentiment: Buy

  • Reply to

    New Case Report Sepsis Due To H1N1

    by berthabluefish May 24, 2016 2:03 AM
    andy55q andy55q May 24, 2016 7:22 AM Flag

    Case of the week 20/2016
    CytoSorb in pneumogenic sepsis due to influenza A H1N1

    Dr. Markus Nitsch & Dr. Hendrik Liedtke, Clinic for Anaesthesiology, Intensive Care, Palliative, Emergency Medicine and Pain Therapy, Hospital St. Elisabeth and St. Barbara Halle (Saale) GmbH, Germany
    This case study reports on a 68-year-old male patient (medical history of COPD IV°, atrial fibrillation hypertension and chronic nicotine and alcohol abuse) who was admitted to the hospital by emergency medical service.
    Case presentation

    Direct transfer from emergency department to ICU under non-invasive ventilation
    Intubation and invasive ventilation due to persistent hypercapnia (respiratory acidosis)
    CT diagnosis did not show acute infiltration, at bronchoscopy no secretion in bronchi visible, bronchial wall thickening due to COPD was the only abnormality
    In the further course significantly increasing needs for volume and norepinephrine (2.3 µg/kg/min)
    Suspicion for pneumogenic sepsis with immediate start of antibiotic therapy (piperacillin/tazobactam)
    Progressing renal failure with oliguria up to anuria
    Increase of pCO2 to 18 kPa, pO2 15 kPa at FiO2 of 0.5, pH 7.04
    Increased inflammatory parameters: PCT 1.28 ng/ml, CRP 114.4 mg/l
    Microbiological finding: Influenza A H1N1 (from bronchoscopy at admission)
    Due to pneumogenic sepsis and increasing needs for catecholamines and volume, CytoSorb was started simultaneously with CRRT
    Treatment

    Two CytoSorb treatment sessions for 24 hours each (pause interval of 3 hours between both treatment sessions)
    CytoSorb was used in conjunction with citrate dialysis (Multifiltrate; Fresenius Medical Care) in CVVHD mode
    Anticoagulation: citrate
    CytoSorb adsorber position: pre-hemofilter
    Measurements

    Demand for catecholamines
    Demand for volume
    Inflammatory parameters (PCT, CRP)
    Results

    Norepinephrine could be reduced as early as 6 hours after start of CytoSorb – first to 1.8 µg/kg/min and to 0.6 µg/kg/min over the next 24 hours
    After stop of the first CytoSorb treatment the norepinephrine dosage had to be increased again to 2 µg/kg/min
    After start of the second CytoSorb treatment, noradrenaline could be tapered off within the next 12 hours
    Volume requirement declined significantly over this time
    PCT and CRP plasma levels initially increased but continued to fall in the further course following the second treatment session
    Patient Follow-Up

    Cessation of renal replacement therapy 2 days after the last CytoSorb treatment with full recovery of spontaneous diuresis after stimulation with diuretics
    Weaning trials over 6 weeks after the end of CytoSorb, thereafter adjustment to non-invasive ventilation
    Transfer to pneumology department with persistent critical illness myopathy and neuropathy
    Discharge from hospital 10 weeks after initial admission into early stage rehabilitation
    Conclusions

    Remarkable stabilization of hemodynamics with declining catecholamine and volume requirements under CytoSorb within 48 hours
    According to medical team they were positively surprised because of the rapid stabilization of the patient and due to the fact that catecholamines could be tapered off that rapidly
    Handling of the adsorber was easy and safe

    Sentiment: Buy

  • Reply to

    New May Investor Presentation

    by berthabluefish May 23, 2016 12:27 AM
    andy55q andy55q May 23, 2016 11:13 AM Flag

    Yes,I will be attending. I am in CT. I went to last years meeting. I recommend going. We should have the complete management team at the meeting.

    Sentiment: Buy

  • Reply to

    New May Investor Presentation

    by berthabluefish May 23, 2016 12:27 AM
    andy55q andy55q May 23, 2016 10:35 AM Flag

    Canada coming on-line soon and many other countries

    Sentiment: Buy

  • Reply to

    Renal & Urology News May 17,2016

    by berthabluefish May 19, 2016 10:11 AM
    andy55q andy55q May 19, 2016 10:39 AM Flag

    No Survival Advantage With Early Renal-Replacement Therapy in AKI

    (HealthDay News) -- For patients with severe acute kidney injury, mortality does not differ with either an early or delayed strategy for renal-replacement therapy initiation, according to a study published online in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the American Thoracic Society, held from May 13 to 18 in San Francisco.

    Stéphane Gaudry, MD, from the Hôpital Louis Mourier in Colombes, France, and colleagues from the Artificial Kidney Initiation in Kidney Injury Study Group conducted a multicenter randomized trial in which 620 patients with severe acute kidney injury were randomized to an early or delayed strategy of renal-replacement therapy. Renal-replacement therapy was started immediately after randomization with the early strategy, while with the delayed strategy it was initiated if 1 or more of the following criteria were met: severe hyperkalemia, metabolic acidosis, pulmonary edema, blood urea nitrogen level above 112 mg/dL, or oliguria for more than 72 hours after randomization.

    The researchers observed no significant difference in Kaplan-Meier estimates of mortality at day 60 for the early and delayed strategy groups (48.5 versus 49.7%; P = 0.79). Forty-nine percent of patients in the delayed strategy group did not receive renal-replacement therapy.

    "We found no significant difference with regard to mortality between an early and a delayed strategy for the initiation of renal-replacement therapy," the authors write.

    Sentiment: Buy

  • andy55q andy55q May 19, 2016 7:12 AM Flag

    An increase to sales staff

  • Reply to

    "Acid Reflux"

    by azben43 May 19, 2016 3:36 AM
    andy55q andy55q May 19, 2016 7:03 AM Flag

    But it seems that according to new research published in the Journal of the American Medical Association, that acid reflux disease may be a misnomer. It seems that acid reflux (also known as gastroesophageal reflux disease, or GERD) acid isn’t actually the direct cause of damage to the esophagus. Instead, the damage takes place when secretions of proteins called cytokines produce an inflammatory response in the esophagus.

    Sentiment: Buy

  • We are looking to further strengthen our team:

    Regional Sales Manager / in
    Germany west
    Germany south
    Switzerland
    Austria

    Product and application specialist / in Northern Germany

    Sales Manager International Asia

    Manager Clinical Affairs

    Teaching assistant / in - Study nurse

    Manager Reimbursement International

    Manager Accounting / Controlling

    Sentiment: Buy

  • Cytokine Clearance With Cytoabsorbant Device During Cardiac Bypass (CCCC)
    This study is not yet open for participant recruitment. (see Contacts and Locations)
    Verified May 2016 by Centre Hospitalier Universitaire Vaudois
    Sponsor:
    Centre Hospitalier Universitaire Vaudois
    Information provided by (Responsible Party):
    Antoine Schneider, Centre Hospitalier Universitaire Vaudois
    Study First Received: April 21, 2016
    Last Updated: May 13, 2016
    Health Authority: Switzerland: Cantonal Office of Public Health

    Sentiment: Buy

  • andy55q andy55q May 18, 2016 10:13 AM Flag

    LECTURES
    I. Thomas Rimmele, Lyon, France « Sepsis-induced immunosuppression in the intensive care unit»
    II. Zsolt Molnár, Seged, Hungary «The rationale and clinical benefit of cytokine removal in septic shock»
    (With the support of the company "CytoSorb")

    Sentiment: Buy

  • Moscow
    June 3 – 4, 2016

    Dear Colleagues, Participants and Guests of the Conference!

    The years insensibly passed since the first Russian Conference dedicated to the problems of extracorporeal hemocorrection in patients of the intensive care units was held in 1988. And now we have been already meeting for the tenth time in the hospitable “Heart House” on Rublevskoe highway in June 2016. Of course, analyzing the results of the previous forums, it should be said about the importance of these meetings for the development of intensive care in our country. Just have a look what a wide variety of methods of extracorporeal treatment has become available for the experts who work with the population of critically ill patients. It notes that more and more clinics almost routinely use different methods of extracorporeal blood correction. Today it is difficult to imagine a modern intensive care unit which is not performing the extracorporeal procedures. Undoubtedly, this contributed to our regular meetings over the past 18 years, where the leading experts from Russia and abroad shared their successes and achievements with us and determined the direction of further studies. Year by year there has been progress in the level of reports provided by local authors starting from uninteresting messages within the framework of the first conference and finishing by the argumentative and thoughtful answers within the next forums. Thus, assessing the results of the last 10 conferences, one can certainly say that they have been of great benefit to the development of clinical medicine in the country. The main objectives of our following meetings should be the evaluation of the effectiveness of new methods of extracorporeal blood correction and their introduction into clinical practice, organization and conduction of fundamental and large multicenter randomized trials.

    The scientific program of the conference traditionally includes problems of diagnostics and extracorporeal treatment of acute kidney injury and acute liver failure in children and adults. One of the sections will be fully devoted to the questions of diagnosis and intensive therapy of kidney injury in patients after cardiac surgery as one of the most common causes of renal dysfunction. The possibility of using extracorporeal techniques in the treatment of sepsis will also be fully discussed. The reports will present the results of various sorption cartridges, made both by domestic and foreign manufacturers, and much more other things.

    As previously, the leading researchers from Europe, Japan and the USA will take part in the conference. We will be extremely pleased to welcome Professor Ravindra Mehta, a well-known nephrologist from the USA who took an active part in the first our conference 18 years ago. Another famous nephrologist from the UK is Marlies Ostermann who will give lectures on the effectiveness of the use of high doses of loop diuretics in patients in the intensive care unit and the possibilities of extracorporeal blood correction in the treatment of acute pancreatitis. One of the founders of the current concepts of the pathophysiology and pathogenesis of sepsis, Professor Steven Opal from the United States will reveal the principles of the modern classification of sepsis and provide new data on the clinical application of extracorporeal sorption methods in the intensive care of this severe pathology. French scientist, Thomas Rimmele, will present data on sepsis-induced immunosuppression in the patients in the ICU, and Professor Zsolt Molnar from Hungary will talk about his clinical experience in using «CytoSorb» columns for the purpose of cytokine elimination in septic shock. Interesting topics are stated in the framework of the satellite symposia, organized by general partners of the conference and world leaders in the production of equipment and accessories for efferent treatments – “Fresenius Medical Care” and ZAO "Fresenius SP" (Germany - Russia), as well as "B/B Medical" and “Toray” (Russia - Japan).

    The Organizing Committee of IX Conference "Actual aspects of extracorporeal blood purification in intensive care" invites all specialists of our country to take an active part in the regular forum. We sincerely hope that presented reports and lectures will allow the delegates and guests of the conference to evaluate and interpret the results of their own daily work, introduce new methods of diagnosis and treatment and increase work efficiency of professionals from the ICU.

    Sentiment: Buy

  • andy55q andy55q May 18, 2016 7:22 AM Flag

    Case of the week 19/2016
    CytoSorb in septic shock with multiple organ failure and ARDS (fast-in/fast-out)

    Dr. Martin Bergold, Senior Consultant Clinic for Anaesthesiology, Intensive Care Medicine and Pain Management, Evangelisches Krankenhaus Oldenburg, Germany
    This case study reports on a 64-year-old male patient (medical history of arterial hypertension and insulin-dependent diabetes mellitus) who all of a sudden deteriorated massively (hemodynamically and respiratory) during his 3-week hitherto uneventful neurological first stage rehabilitation after media and cerebellar infarction.
    Case presentation

    Diagnosis of sepsis with immediate start of antibiotic therapy (piperacillin/tazobactam)
    Despite antibiotic therapy further aggravation of his clinical condition all the way to septic shock with further change of antibiotic regimen to Meropenem and Teicoplanin
    Unstable hemodynamics despite 0.35 µg/kg/min norepinephrine: cardiac index 2.3 l/min/m2, SVRI 1100 dyn*s*cm-5*m², ELWI 16 ml/kg, lactate 6.7 mmol/l
    Sharp increase of inflammatory parameters PCT 1.28 ng/ml, IL-6 7315 pg/ml, leucocytes 70.000/µl, CRP 4.9 mg/dl
    Development of ARDS with proof of pseudomonas spec and diagnosis of pseudomonas-pneumonia
    Despite initial spontaneous diuresis and normal retention parameters renal function deteriorated rapidly
    Due to acute anuric renal failure, sharp increase of inflammatory markers and progressive need for catecholamine and septic shock with multiple organ failure CytoSorb was started simultaneously with CRRT
    Treatment

    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
    Anticoagulation: citrate
    CytoSorb adsorber position: pre-hemofilter
    Measurements

    Demand for catecholamines
    Inflammatory parameters (IL-6, PCT, CRP, leucocytes)
    Renal function (excretion)
    Lactate
    Results

    Clear stabilization of hemodynamics during the course of the three CytoSorb treatments under 0.25 µg/kg/min norepinephrine and vasopressin: cardiac index now 3.54 l/min/m2, SVRI 1600 dyn*s*cm-5*m², ELWI 8 ml/kg, in TEE LV-EF 30-40%
    Decrease of inflammatory parameters during the course of the three CytoSorb treatments: IL-6 to 1871 pg/ml, PCT to 0.44 ng/ml, CRP to 7.9 mg/dl, leucocytes to 8700/µl
    Lactate level stable at 2.2 mmol/l
    Patient Follow-Up

    Cessation of renal replacement therapy 6 days after the last CytoSorb treatment
    Complete recovery after acute septic phase with exception for his neurologic underlying problem (rehabilitation due to media and cerebellar infarction)
    Transfer to neurological first stage rehabilitation
    Conclusions

    Clear stabilization and consolidation of hemodynamics and inflammatory mediators under CytoSorb within 48 hours
    Control of septic shocks within a short period of time
    Handling of the adsorber was easy and safe

    Sentiment: Buy

  • Reply to

    PAMPS and DAMPS Acute Chronic Liver Failure

    by berthabluefish May 16, 2016 6:05 PM
    andy55q andy55q May 16, 2016 10:08 PM Flag

    The Pathogenesis of ACLF: The Inflammatory Response and Immune Function.
    Moreau R1.
    Author information
    1Inserm, U1149, Centre de Recherche sur l'Inflammation (CRI), Clichy and Paris, France.
    Abstract
    Although systemic inflammation is a hallmark of acute-on-chronic liver failure (ACLF), its role in the development of this syndrome is poorly understood. Here the author first summarizes the general principles of the inflammatory response. Inflammation can be triggered by exogenous or endogenous inducers. Important exogenous inducers include bacterial products such as pathogen-associated molecular patterns (PAMPs) and virulence factors. Pathogen-associated molecular patterns elicit inflammation through structural feature recognition (using innate pattern-recognition receptors [PRRs]), whereas virulence factors generally trigger inflammation via functional feature recognition. Endogenous inducers are called danger-associated molecular patterns (DAMPs) and include molecules released by necrotic cells and products of extracellular matrix breakdown. Danger-associated molecular patterns use different PRRs. The purpose of the inflammatory response may differ according to the type of stimulus: The aim of infection-induced inflammation is to decrease pathogen burden, whereas the DAMP-induced inflammation aims to promote tissue repair. An excessive inflammatory response can induce collateral tissue damage (a process called immunopathology). However immunopathology may not be the only mechanism of tissue damage; for example, organ failure can develop because of failed disease tolerance. In this review, the author also discusses how general principles of the inflammatory response can help us to understand the development of ACLF in different contexts: bacterial infection, severe alcoholic hepatitis, and cases in which there is no identifiable trigger.
    Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

    Sentiment: Strong Buy

  • andy55q andy55q May 14, 2016 10:58 AM Flag

    May not have received the official documents in writing.

    Sentiment: Buy

  • 12/05/2016 We are glad to share upcoming events, which we are pleased to announce a portable ultrasound machine anesthesiologist eZono and system for adsorption CytoSorb cytokine . May 2016: We will be taking part in the exhibition at the XIII All-Russian Scientific Conference "Standards and individual approaches anesthesiology and Intensive Care " . This year we introduced a new product for which registration is completed at the end of April 2016 - CytoSorb cytokine adsorption system to fight ARDS, SIRS, sepsis and septic shock produced by Cytosorbents Corp. Come to our stand, are happy to tell in detail about the new product! 3-4 June 2016: Representatives of our company will participate in the exhibition under the X Anniversary International Conference "Actual aspects of extracorporeal blood purification in intensive care" on the basis of the Scientific Center of Cardiovascular Surgery them. AN Bakuleva in city Moscow . Since the registration of a new product ended not so long ago, before we did not have to be part of this conference, but to participate in the Jubilee Conference particularly honorable. Your attention will be presented to the system cytokine adsorption to deal with sepsis and septic shock CytoSorb . Looking forward to seeing you at our booth! also on June 4 welcome to visit the lecture of Professor Hungarian Zsolt Molnera (of Zsolt Molnár) , that sanctify the following topics: 9.30-11.00: "Sepsis and love:? what's in common all" ( "Sepsis and love: what is common?") 15.15-16.45: " the rationale and clinical benefit of cytokine removal in septic shock »(with the support of the company" CytoSorbents ") (« Scientific design and clinical substantiation remove cytokines in septic shock "(with the support of" CytoSorbents "company))

  • DARPA Shows Off Technology at Demo Day
    By Yasmin Tadjdeh
    Dozens of Defense Advanced Research Projects Agency program managers, researchers and engineers descended upon the Pentagon May 11 to show off new technology.

    DARPA Director Arati Prabhakar said the goal of the agency’s demo day is to get the agency's breakthrough technology in front of the right people.

    “Today is the day that we bring some of those crazy technologies out here into the Pentagon so that we can get them in front of our customers and our partners, people across all the military services and across DoD,” she told reporters.

    With 60 program managers at the event, Prabhakar said they would be engaging with Defense Department officials to set up links and work on accelerating the transition of the programs into formal acquisitions.

    One important area of research is in biological technologies, Prabhakar said. DARPA’s newest office — the biological technologies office — was stood up two years ago and does work in infectious diseases, synthetic biology and neurotechnologies.

    “DARPA has been working in biological technologies for now close to two decades but we felt it was an important time to put a special focus there,” she said. “This is one of the areas of research where the pot is bubbling and when you see the pace of research and the pace of the underlying technologies that affect biology that tells us that surprise is going to come from this year and we want to make sure that we understand that and help drive it.”

    The recent Zika and Ebola crises are pointed reminders of the challenges that infectious diseases pose to national security, she said.

    “We also worry about the possibility of engineered biological threats,” Prabhakar said. “All of those argue for a future where we have a much faster way to nip disease in the bud.”

    One piece of technology under the biological technologies office is the dialysis-like therapeutics program. Using a lightweight, affordable and portable system, DARPA wants to filter the blood of a sick patient and remove pathogens, toxins and harmful bacteria, said the system’s program manager Army Col. Matthew Hepburn.

    “The point is [to] make dialysis portable but then also make filters so that you can remove bacteria or viruses from the blood so that if you’re sick with an infection, especially infections that don’t have antibiotics that work, then you would be able to hook up to a dialysis machine and they would remove that bacteria,” he said.

    Instead of designing a slew of filters to remove specific pathogens, researchers are developing a single filter that can remove any type of bacteria by finding markers that are common to all bacteria, he said. Ideally, it would be used in a battalion aid station, he added.

    The program has been in the works for four years and is undergoing animal testing through fiscal year 2017. The following year, it will begin clinical trials for humans and will have transitioned out of DARPA by that time, Hepburn said.

    “The program ends before the human clinical trials because we would sort of consider that we’ve done our part and then we’re going to have transition partners … in military medical research,” he said.

    The system is between 50 and 100 pounds. It is still in prototype stage, so the final form factor has not yet been determined.

    Another piece of technology that goes hand in hand with the dialysis-like therapeutics program is the prophecy – mobile analysis platform.

    The small, portable system can diagnosis infectious diseases in blood, Hepburn said. It can deliver results in under an hour and can then transmit them via a wireless data transmission.

    “When we make an identification of the pathogen … or the infection that is causing you to be sick, that involves taking a sample from a patient [and then] sending it somewhere,” he said. “You have to send that to a laboratory, especially in an operational environment. You may have to send that on a plane all the way back to the United States to get a very accurate diagnosis. This platform is very disruptive.”

    It is designed to be simple enough to use without any training, he added. The program is currently in its third year of development and DARPA is actively working on transitioning it into the commercial world for production, Hepburn said.

    Another piece of technology on display at demo day was “Z-Man” paddles. Developed under DARPA’s defense sciences office, its goal is to give soldiers climbing aids while carrying a full combat load. The paddles are inspired by the toes of geckos, said John Main, Z-Man program manager.

    “We’re trying to duplicate the climbing abilities that geckos have and give it to humans,” he said. “The way the gecko accomplishes this is they have these hair-like structures on the end of their toes.”

    These structures are very fine and short and are about the thickness of a human hair. “They’re very compliant and what it allows you to do is press against the wall and take advantage of what is called van der Waals forces, which are just contact forces,” he said.

    DARPA, working alongside Draper Labs, developed a synthetic form of the gecko hair that it spread over paddles that a soldier can hold. The material creates an adhesion between the surface and the paddle allowing a user to climb a glass wall or other smooth surfaces. The paddles weigh about six pounds each.

    DARPA has also designed another version — known as “the Hybrid” — that combines suction cup technology with the synthetic gecko material to create a more robust paddle, he said.

    “This is probably the ultimate embodiment of the gecko technology. The gecko stuff is great if you’re sliding, but not so great if you’re pulling. The suction cups are great if you’re pulling but not so much if you’re sliding. So if you put them together you get something that’s great for pulling and sliding,” he said.

  • andy55q andy55q May 11, 2016 7:06 AM Flag

    CytoSorb in Staph aureus sepsis and myositis-associated rhabdomyolysis

    Katrin Przybilla and Andreas Bauer; Medical Clinic, Department of Intensive Care Medicine; Diakonissen Hospital Dresden, Germany
    This case study reports on a 61-year-old female patient who presented at the hospital with fever, vomitus and signs of sepsis a few days after completion of her 11th cycle of adjuvant chemotherapy with Paclitaxel due to mamma carcinoma.
    Case presentation

    Rapid deterioration of her hemodynamic situation and kidney function
    High plasma levels of inflammatory markers – leucocytes 24.000/µl, CRP 380 mg/l, PCT 45.1 ng/ml
    Additional clinically pronounced myositis (muscle inflammation) with myoglobin plasma levels of 6049 µg/l
    Erythema multiforme with proof of Staph aureus in wounds and suspicion of toxic shock syndrome
    Development of acute anuric renal failure with immediate initiation of citrate dialysis (CVVHD)
    Progressive deterioration of hemodynamic condition with high need for catecholamines (norepinephrine 4 mg/h)
    In the further course fulminant septic shock with renal and circulatory failure as well as highly elevated markers of inflammation resulting in the installation of CytoSorb into the CRRT circuit
    Treatment

    One CytoSorb treatment session for 24 hours
    CytoSorb was used in conjunction with citrate dialysis (Multifiltrate; Fresenius Medical Care) in CVVHD mode
    Additionally, an EMic2 filter was installed for the treatment of highly elevated myoglobin plasma concentrations (CytoSorb in series before EMiC2 filter)
    Blood flow rate: 150 ml/min
    Anticoagulation: citrate
    CytoSorb adsorber position: pre-hemofilter
    Measurements

    Demand for catecholamines
    Inflammatory parameters (leucocytes, CRP, PCT)
    Myoglobin plasma concentration
    Results

    Hemodynamic stabilization with reduction of catecholamine dosages to 2 mg after termination of CytoSorb treatment and gradual weaning from catecholamines with complete stop 4 days after start of CytoSorb therapy
    Leucocytes fell to 18000/µl four hours after start of CytoSorb treatment and continued to decrease to normal values in the further course
    CRP plasma levels decreased to 260 mg/l four hours after start of CytoSorb treatment and to 85 mg/l in the further course
    PCT could be reduced to 13.7 mg/l after 24 hours of CytoSorb treatment
    Myoglobin plasma concentrations were reduced to 3168 µg/l and to 665 mg/l in the further course
    Patient Follow-Up

    Further improvement of all organ functions in the following days
    Following intermittent termination attempts CRRT could be stopped 16 days after start of CytoSorb therapy
    Patient could be discharged to rehabilitation with persistent critical illness myopathy and neuropathy 32 days after CytoSorb treatment
    Conclusions

    Combined treatment of CRRT with CytoSorb resulted in a clear and quick stabilization of hemodynamics with declining needs for catecholamines and a significant reduction of inflammatory mediators
    The combined application of CytoSorb and the EMiC2 filter was also associated with a rapid reduction of myoglobin plasma levels as a result of myositis-associated rhabdomyolysis
    For the treating physicians, this was the 2nd case with an excellent experience using CytoSorb in a patient with fulminant septic shock
    Handling of the adsorber was easy and safe

    Sentiment: Buy

  • Drug-free treatment for neuropathy

    To help my own patients, I introduced FDA-cleared Calmare Pain Therapy Treatment (scrambler therapy), a U.S. FDA 510(k)-cleared and European CE mark-certified, non-invasive pain therapy device. This free-standing device is painless for the patient, has no side effects and requires no medication.

    The device was developed by Professor Giuseppe Marineo, a researcher and bioengineer and the founder and manager of Delta Research & Development, affiliated with Tor Vergata University of Rome, Italy.

  • andy55q andy55q May 9, 2016 11:47 AM Flag

    Medical Advisory Board
    PULSION's Medical Advisory Board (MAB) is an international group of leading scientists and well-known physicians with different specialties. They support PULSION in all clinical, medical, and marketing matters with their expertise.
    Medical Advisory Board Members:
    Javier Belda, MD, Professor
    Head of Department of Anaesthesia and Surgical Critical Care
    University of Valencia, School of Medicine, Valencia, Spain
    Alwin Goetz, MD, Professor and Chairman
    Department of Anesthesiology and Intensive Care Medicine,
    University Clinic Hamburg-Eppendorf, Germany
    Wolfgang Huber, MD, Professor
    2nd Medical Department, Klinikum Rechts der Isar
    Technical University of Munich, Germany
    Mikhail Kirov, MD, Professor
    Department of Anaesthesiology and Intensive Care Medicine,
    Northern State Medical University, Arkhangelsk, Russia
    Claus-Georg Krenn, MD, Professor
    Austrian Society of Anaesthesiology, Reanimation and Intensive Care (ÖGARI)
    Department of Anaesthesiology and General Intensive Care,
    Medical University Vienna, Austria
    Marco Maggiorini, MD, Professor
    Head of the Medical ICU of the Department of Internal Medicine,
    University Hospital Zürich, Switzerland
    Manu Malbrain, MD, PhD
    Hospital Medical Director, ICU and High Care Burn Unit Director,
    Zieken Huis Netwerk, Campus Stuivenberg,Antwerp, Belgium
    Greg Martin, MD, Assistant Professor
    Director of Medical and Coronary Intensive Care Units,
    Emory University School of Medicine, Grady Memorial Hospital,
    Atlanta, Georgia, USA
    Zsolt Molnar, MD, PhD, Professor
    Head of Department of Anaesthesiology and Intensive Therapy
    University of Szeged, Hungary
    Enrique Fernández Mondéjar, MD, Associate Professor
    Dept for Intensive Care Medicine, Trauma
    University Clinic Virgen de las Nieves, Granada, Spain
    Xavier Monnet, MD, Professor
    Service de Réanimation médicale,
    Centre Hospitalier Universitaire de Bicètre, Paris, France
    Azriel Perel, MD, Professor and Chairman
    Professor of Anaesthesiology and Intensive Care,
    Sheba Medical Center, Tel Aviv University, Tel Hashomer, Israel
    Kees H Polderman, MD, PhD
    Medical Director, Neurocritical Care Services
    University of Pittsburgh School of Medicine, Pittsburgh, USA
    Christian Putensen, MD, Professor
    Clinic for Anesthesia and Intensive Care Medicine,
    Rheinische-Friedrich-Wilhelms-University, Bonn, Germany
    Michael Quintel, MD, Professor and Chairman
    Anaesthesiology II Operative Intensive Care,
    University Clinic Göttingen, Germany
    Daniel Reuter, MD, Professor
    Professor of Anesthesiology and Vice Chair,
    Department of Anesthesiology and Intensive Care Medicine,
    University Clinic Hamburg-Eppendorf, Germany
    Samir Sakka, MD, Professor
    Head of Surgical Intensive Care
    Department of Anesthesiology and Surgical Intensive Care
    Hospital Cologne -Merheim, Germany
    Bernd Saugel, MD, PhD
    Department of Anesthesiology
    Center of Anesthesiology and Intensive Care Medicine
    University Medical Center Hamburg-Eppendorf, Germany
    Eran Segal, MD
    Director, Anesthesia and Intensive Care
    Assuta Medical Centers, Israel
    Tasuhiko Taira, MD, Professor
    Dept Emergency and Critical Care Medicine
    St Marianna University School of Medicine Hospital
    Kanagawa, Japan
    Jean-Louis Teboul, MD, Professor
    Service de Réanimation médicale,
    Centre Hospitalier Universitaire de Bicètre, Paris, France
    Julia Wendon, MD, Professor
    Senior Lecturer and Honorary Consultant
    Liver Intensive Care,
    King`s College Hospital, London, United Kingdom

    Sentiment: Buy

  • andy55q andy55q May 5, 2016 7:06 AM Flag

    The use of cardiopulmonary bypass (CPB) in cardiothoracic surgery results in a well-known activation of the immunologic response. In some cases, however, this triggered immunologic response may be excessive, leading to a severe systemic inflammatory response syndrome (SIRS) and induced organ dysfunction. For example, patients frequently develop hemodynamic instability with hypotension and low systemic vascular resistance. To date, different therapeutic approaches, such as steroids, have been tried to control this maladaptive postoperative SIRS response, yet definitive proof of clinical efficacy is missing. A new cytokine adsorber device (CytoSorb; CytoSorbents) may be a useful approach to control hyperinflammatory systemic reactions by reducing a broad range of proinflammatory cytokines and other inflammatory mediators. This may, in turn, help to reestablish a physiologic immune response and help to restore deranged clinical parameters in these patients. In this retrospective case series study, we describe 16 cardiac surgery patients following prolonged CPB with post-CPB SIRS and subsequent acute kidney injury, who were then treated with hemoadsorption using CytoSorb in combination with continuous renal replacement therapy (CRRT). Treatment of patients with CytoSorb who presented with severe post-CPB SIRS resulted in a reduction of elevated cytokine levels, which was associated with a clear stabilization of deranged hemodynamic, metabolic, and organ function parameters. Treatment was well tolerated and safe, with no device-related adverse events occurring. CytoSorb therapy combined with CRRT is a potentially promising new treatment approach to achieve hemodynamic stability, cytokine reduction, and improved organ function in cardiac surgery patients who develop post-CPB SIRS.

SYK
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