Masterclass Satellite Symposium (Cytosorb ): Fix the leaky bucket to prevent fluid overload - How Cytosorb stops capillary leakage
• Presenter: Dr. Karl Traeger, MD, PhD - Professor and Head of Cardiosurgical Intensive Care Unit, Cardiac Anaesthesia Department, University Hospital Ulm, Ulm, Germany
• Time: Friday, 28. November 2014, 14:00 pm (CEST)
• Location: Room Lijn, Hilton Antwerp
For more details: International Fluid Academy
In this Session you will learn about:
• The overproduction of cytokines by the immune system, often called “cytokine storm”, is a hallmark of many life-threatening illnesses seen in the ICU such as severe sepsis and septic shock
• A cytokine storm can be toxic, causing direct cell death, massive capillary leakage, severe inflammation, and a cascade of events that can ultimately lead to shock and multiple organ failure
• At the heart of the Cytosorb® technology is a biocompatible, highly porous polymer designed to capture and adsorb cytokines in the ~10-50 kDa “cytokine sweet spot” where most cytokines reside
• The goal is to reduce toxic cytokine levels to prevent or mitigate organ failure and immune suppression, and to seal the capillary leak, thereby improving clinical outcome
• Key-learning issues during this lecture:
o Recognize the role of uncontrolled immune response for clinical changes of vascular tone, hemodynamic changes, capillary permeability, organ dysfunction
o Recognize the parameters of proinflammatory cytokines and the course of their activation in the context of inflammatory diseases
o Review different approaches of blood purification for modulation of cytokine levels
o Learn the effects of bead adsorber technology for cytokine removal
o Recognize different indications for hemadsorption therapy
Udwadia, who will present the keynote address Nov. 19, works with some of the poorest patients in Mumbai and recently created a stir by publishing a report describing patients with "totally drug-resistant tuberculosis." He was urged to change the term to "extremely drug-resistant" TB or "XDR-TB." He will comment on the health infrastructure and regulatory failures that are leading to an explosion of XDR-TB in India.
Driving adoption of a novel medical is almost always a difficult proposition and the adoption curve is often flat, drawn out and variable. It is also often ultimately a failure. As such we would characterize CTSO's roll-out as relatively highly successful and offering compelling promise.
Doctors in Germany used Aethlon Medical’s biofiltration technology to treat a patient infected with the Ebola virus, following emergency use authorization from the German government.
The Hemopurifier targets the rapid elimination of viruses and immunosuppressive proteins by filtering infected blood through a bundle of hollow, porous fibers enclosed in a cylindrical plastic case, explains Aethlon President Rod Kenley. Pressure from a blood pump pushes a fraction of the plasma through a porous membrane, leaving the cellular components of the blood inside the fibers.
Once this is done, the virus passes through the membrane’s pores and is absorbed by affinity resin just outside the fibers. The plasma then reenters the fibers and recombines with the blood, which is reintroduced into the patient with a much lower concentration of viruses.
Kenley said the device was based on an off-the-shelf plasma filter, and is similar to an artificial kidney.
The treatment reduces the viral load more rapidly than drug therapy, enhancing the immune system’s ability to attack and overcome the diminished amount of the virus, he adds.
Originally developed to treat HIV and hepatitis C, the Hemopurifier has been the subject of clinical trials in India since 2007. In a recent trial there, it cured five out of seven genotype 1 HCV patients, according to Kenley.
The FDA granted Aethlon approval to evaluate the Hemopurifier as a treatment for HIV and HCV in 2013. More recently, the agency authorized the device’s use as an emergency intervention for Ebola patients.
Studies of the device in Ebola-infected monkey blood and cell cultures, conducted at the United States Army Medical Research Institute for Infectious Diseases, showed it to be effective in binding and extracting the virus from blood. — Kellen Owings
Go to AEMD or CTSO IHUB for link, can not post it here.
Go to CTSO IHUB for link
A top official with the U.N. health agency says few experimental therapies are currently under development that could effectively treat Ebola.
A top official with the U.N. health agency says few experimental therapies are currently under development that could effectively treat Ebola.
Dr. Martin Friede, who is in charge of the World Health Organization's work toward finding an Ebola drug, says scientists have proposed lots of experimental interventions but none has been thoroughly evaluated yet.
"We don't have a lot of drugs in our pipeline that look promising," said Friede, program leader for WHO's technology transfer initiative. His comments follow a WHO-sponsored meeting of medical experts this week on how to test potential Ebola drugs in Africa.
Friede told reporters Friday in Geneva that "people are using all kinds of therapies" for the deadly virus without evidence they're effective or safe.
Blood-Filtering Ebola Device Ready for Testing
Posted in Research and Development by Kristopher Sturgis on November 13, 2014
A new Ebola treatment device known as the Aethlon Hemopurifier is scheduled to begin U.S. clinical trials by the end of this year, after receiving the green light for trials from the FDA. The device received significant backing following news of a German patient suffering from Ebola that was declared free of the virus, and on the road to a complete recovery.
In a recent news release from Aethlon Medical Inc, the company describes the device as a first-in-class biofiltration device that targets the rapid elimination of viruses and immunosuppressive proteins from the circulatory system of infected individuals. Currently, there is no active antiviral therapy or vaccine that has proven to be effective against the Ebola virus in humans, which could make the Aethlon Hemopurifier an important treatment option.
The device is essentially a blood-filtering cartridge containing “affinity” agents that attract and capture specific viruses and immunosuppressive proteins. The filter works by hindering the virus’s ability to replicate while allowing the immune system to react and rebound. The device made waves when doctors in Germany reported last week that a patient infected with Ebola had recovered after he was treated with the device in conjunction with other therapies, including antiviral drugs.
The device can be easily hooked up to a dialysis machine and quickly begins to eliminate the circulation of viruses to inhibit growth, as well as directly targeting secreted glycoproteins that can overwhelm the immune system response. The device proved to be an effective treatment despite the patient suffering from multiple organ failure as result of the Ebola virus.
Despite the overwhelming nature of the virus’s recent rise, the increased attention has catalyzed both innovation and action. Not only have hospitals around the globe been forced to revisit their procedures for handling a possible Ebola patient, but the increased sense of danger has sparked innovation and accelerated the need for cutting edge solutions in diagnostics and treatment options.
As for the clinical trials for this new treatment device, the company said they will be based on FDA approval of an Investigational Device Exemption, which if approved, could essentially help the company fast track the device from trials to actual practical use. The study will also contribute safety data to advance the device, so it could be used to fight pandemic threats from Ebola, as well as other chronic viral pathogens such as HIV and hepatitis C.
Aethlon announced in a news release that the treatment data resulting from the administration of the device to a patient suffering from Ebola will be presented Friday, November 14 at the American Society of Nephrology’s annual meeting, during a special session on Ebola and dialysis. The data will include the results of patient viral load measurements taken before and after the administration of the Aethlon Hemopurifier.
For now, the potential applications for this device are still being explored, as researchers believe the device could be useful across a broad spectrum of viruses, and possibly even as a treatment option for certain cancers. While the concern over the spread of Ebola continues to rise, this new device could be the first real innovative solution to stifle the spread of Ebola and other dangerous viral pathogens.
1 Not yet recruiting Use of Extracorporeal Treatment With the Cytosorb-Adsorber for the Reduction of SIRS in Heart Surgery Patients
Condition: Multiple Organ Failure
Intervention: Device: Extracorporeal treatment with the Cytosorb adsorber
2 Completed Efficacy Study of CytoSorb Hemoperfusion Device on IL-6 Removal in ARDS/ALI Patients With Sepsis
Conditions: Acute Respiratory Distress Syndrome; Acute Lung Injury; Sepsis
Intervention: Device: CytoSorb Hemoperfusion
3 Recruiting Cytokine Removal in Cardiopulmonary Bypass Patients
Condition: Elective Cardiac Surgical Interventions
Intervention: Device: CytoSorb
4 Active, not recruiting The Effect of Early Cytokine Absorption on the SIRS and Organ Dysfunction in the First 48 Hours of Septic Shock
Conditions: Sepsis; Septic Shock
Intervention: Device: CytoSorb 300ml device (3804606CE01)
5 Recruiting Extracorporeal Therapy for the Removal of Myoglobin Using the CytoSorb in Patients With Rhabdomyolysis
Interventions: Device: CytoSorb Device; Procedure: CVVH
6 Recruiting Clinical Impact of Cytokine in Cardiac Surgery
Condition: Coronary Disease
Intervention: Removal of Cytokine on Cardiopulmonary Bypass With CytoSorb® Compared to on- and Off-pump Myocardial Revascularization
The systemic immune response to trauma: an overview of pathophysiology and treatment.
Lord JM1, Midwinter MJ2, Chen YF3, Belli A4, Brohi K5, Kovacs EJ6, Koenderman L7, Kubes P8, Lilford RJ9.
Improvements in the control of haemorrhage after trauma have resulted in the survival of many people who would otherwise have died from the initial loss of blood. However, the danger is not over once bleeding has been arrested and blood pressure restored. Two-thirds of patients who die following major trauma now do so as a result of causes other than exsanguination. Trauma evokes a systemic reaction that includes an acute, non-specific, immune response associated, paradoxically, with reduced resistance to infection. The result is damage to multiple organs caused by the initial cascade of inflammation aggravated by subsequent sepsis to which the body has become susceptible. This Series examines the biological mechanisms and clinical implications of the cascade of events caused by large-scale trauma that leads to multiorgan failure and death, despite the stemming of blood loss. Furthermore, the stark and robust epidemiological finding--namely, that age has a profound influence on the chances of surviving trauma irrespective of the nature and severity of the injury--will be explored. Advances in our understanding of the inflammatory response to trauma, the impact of ageing on this response, and how this information has led to new and emerging treatments aimed at combating immune dysregulation and reduced immunity after injury will also be discussed.
"Health experts say the recovery of the patient is exciting because it helps to validate the concept of removing viruses from the blood, versus, or in addition to, attempting to treat infections with anti-viral medications."
Michael Mawanda, the Ugandan doctor admitted in Germany for specializedtreatment after contracting Ebola in Sierra Leone in October, is no longer infected with the disease, Chimp Corps report.
Dr Mawanda, a paediatrician with an Italian NGO, was on October 3 flown in a chartered plane from Lungi Airport in Sierra Leone to Germany after falling ill.
At the time, Ugandan officials said they had received information about Mawanda’s health status but that he was not among doctors dispatched by government to reinforce West Africa’s efforts in the battle against Ebola.
For more than four weeks, the Ebola patient was being treated at the University Hospital Frankfurt.
The hospital said in a statement seen by this website on Thursday that, “In the meantime he was ill and suffered from a critical multi-organ failure” and that, “Therefore, he needed intensive medical therapy including organ replacement procedures.”
The medical facility further said using these methods; it has managed to “bridge the time until the onset of proprietary antibody production.”
Currently, the statement reads, “the patient is awake, can autonomously move around the hospital room, eat normally and has no pain.”
However, Mawanda “will still need some time to fully recover from his very serious illness. It is planned that the patient remains on the isolation ward.”
“My thanks and deep respect goes to the physicians and nurses who not only saved a man who risked his life to help others. They have also shown that the Frankfurt University Hospital provides cutting-edge medicine at the highest level and Hesse is very well prepared for the treatment of Ebola patients, ” said Stefan Grüttner, a health official.
Prof. J. Schölmerich, Medical Director and Chief Executive Officer of the University Hospital Frankfurt, said, the healing was possible because of the “tireless efforts of our volunteers and medical staff who have all worked under high physical stress.”
Health experts say the recovery of the patient is exciting because it helps to validate the concept of removing viruses from the blood, versus, or in addition to, attempting to treat infections with anti-viral medications.
Mawanda becomes the second Ebola patient to be treated at the time of his check-in at the medical facility.
The third patient who was a Sudanese doctor admitted in Leipzig, died in mid-October.
Ebola has killed over 4,000 people in West Africa. Several cases have since been confirmed in Mali.
Yet again, no explanation for why Spectral, with its Toraymyxin license, will take off here, assuming 100% that it is approved, when the licensor, Toray, has had net sales of less than $500k for each of 2011, 2012 and 2013 for its entire Life Science division (more products than just this one) even though the product has been approved in Japan for over 20 years. Please explain or just leave this board.
The aim of the study is to investigate the effect of CytoSorb® treatment within the first 48 hours of septic shock on organ dysfunction, microcirculation and on the cytokine storm as monitored by leukocyte activation and inflammatory mediators.
he Effect of Early Cytokine Absorption on the SIRS and Organ Dysfunction in the First 48 Hours of Septic Shock
This study is ongoing, but not recruiting participants.
Information provided by (Responsible Party):
Domonkos Trásy, Szeged University
First received: November 5, 2014
Last updated: November 12, 2014
Last verified: November 2014
and for the first time have hope for a cure: A new medical technology can stop the deadly disease.
As Mariana Bridi was 20, admitted shortly after Christmas in a Brazilian hospital, she looked amazing and she was still relatively good. She had elevated temperature, and the doctors diagnosed at the top model an infection of the urethra, nothing earth shattering. Then, within days, her condition worsened dramatically, the doctors lost control. The kidneys failed, hands and feet began to die. In emergency operations, their limbs the kidney and a portion of the stomach were amputated away - too late. End of January died the supermodel from sepsis to German: blood poisoning.
That was in 2009, and since then more than 130 million people worldwide are suffering from sepsis, nearly 45 million have died from the debilitating disease, including many celebrities. The sepsis-victims include Prince Rainer of Monaco, Superman actor Christopher Reeves, publisher Rudolf Augstein, Chancellor Schmidt's wife Loki and the TV presenter Ilona Christen.
Sepsis is the leading cause of death of children and neonates, the overall infection rate is increasing annually by about ten percent. The National Academies of Sciences of the G-states are already warning of a "global threat to humanity". On September 13 physicians from all over the world therefore commit the World Day sepsis to make to cases such as that of Bridi and the largely unknown and underestimated disease attentive.
Complexes overreaction of the immune system
Calls for Germany calls Professor Konrad Reinhart, chief of the Department of Anesthesiology and Intensive Care Medicine at the University Hospital Jena and Chairman of the German Sepsis foundation of the federal government a "National Action Plan against sepsis". In the Federal Republic of cancer every year about 180,000 people suffer from sepsis, more than 60,000 die - more than by heart attack together or lung, breast and colon cancer. Reinhart believes that a combination of better hygiene measures, vaccination against sepsis pathogens, reconnaissance and other measures can reduce the morbidity and mortality significantly.
Sepsis is a complex overreaction of the immune system to bacteria or fungi, which is so strong that vital body functions are limited and single or multiple organs failure. It occurs as a consequence of infection or after major surgery. The defense system of the body produces in case of an infection called cytokines that coordinate as messengers between the opposing defenders. If the amount of cytokines a certain value, proposes to the defensive struggle: Institutions are no longer protected but harmed.
In the past there have been several attempts to get at the disease by pharmaceutical or medical therapies. But success came from modest or completely. Only now there's a promising new approach that could save the lives of many patients.
The small US company Cytosorbents from New Jersey has developed a cytokine adsorber which removes the hazardous chemical messengers and other inflammatory mediators from the blood: the blood of an infected person is passed through a 20 cm long cylinder, stuck in the tens of thousands of small plastic balls. They are made of highly biocompatible polymers, each of them is perforated with countless tiny holes remain where hang the unwanted molecules. So living dangerously high cytokine levels are reduced to a level at which the body the runaway immune response can control himself again. "We" says Christian Steiner, head of Cytosorbents Europe, "give the doctors an instrument in the hand to regain control of these patients and thus save lives."
In eleven states of the cytokine filter is already used. In Germany more than 40 clinics contact the cartridge successfully, the therapy belongs in the Munich University Hospital Grosshadern and Augustinum for certain patients already as routine as at the University Hospital of Essen, Greifswald and Halle. In more than 20 studies, the effectiveness of the adsorber is being scrutinized - and there are the first results very promising. A decisive factor for the success of the use during long operations seem to be two facts to be: inflammatory mediators such as interleukin 6 are effectively reduced, and the effect persists even after surgery, suggesting that the adsorber exerts an influence on the production of interleukins.
Private online medium for new technology
Whether a 60-year-old who suffered a streptococcal infection after a forearm fracture and was saved thanks to the adsorber, or a 37-year-old man who suffered a staph infection after liver cirrhosis and convalesced - the results of the new form of therapy are consistently positive ,
As fast growing insights into the cytokine-adsorber that Professor Frank Brunkhorst, director of the Center for Clinical Studies at the University Hospital Jena and Secretary General of the German Sepsis Society, in cooperation with the manufacturing company created its own online media for the new technology: In Cytosorb register , users can capture common data centers to use which document safety and efficacy.
Side effects that exist in almost all forms of therapy have so far occurred nowhere. Although it can not be excluded that the small polymer beads also substances from the blood to get that there are desirable - for example, antibiotics that are administered to a bacterial infection. Which could meet, however, by doctors increase the dose of the drug. The relevant data for this purpose are currently collected in several studies.
"Enormous potential in the control of sepsis" therefore sees the senior physician in the Department of Intensive Care Medicine at the University Hospital Hamburg Eppendorf, Axel Nierhaus. Professor Karl carrier, director of the cardiac intensive care unit of Universtätsklinikums Ulm, who proved to be one of the first heart specialists reduction of inflammatory mediators through the adsorber, notes, Cytosorb was a "promising new treatment option" and have "greatest benefit".
What is exactly is still difficult to discern. As the Eppendorf intensivists Nierhaus recently got a suicidal patients on his ward, who had swallowed an overdose of the painkiller paracetamol, it was no more, pump the stomach. The active ingredients of the drug had already paralyzed the liver. Nierhaus put the cytokine filter - and rescued the man and life liver.
2ND CYTOSORB USERS MEETING ON 2 DECEMBER 2014 IN HAMBURG
ear CytoSorb® users,
we kindly invite you to our second CytoSorb® user meeting! This meeting aims at enhancing the dialog between users and anyone interested from Germany, Austria and Switzerland. We would like to offer you an opportunity for sharing experience and discussing topics such as SIRS and sepsis in a relaxed atmosphere.
Once again, you can expect top-class international speakers as well as interesting news. We are confident that you will benefit from the expert talks and from individual discussions. After the scientific program, we would like to invite you for dinner.
Meeting language will be German.
Please register by 4 November 2014 . Attendance is free of charge.
J Card Surg. 2014 Nov 10. doi: 10.1111/jocs.12465. [Epub ahead of print]
Risk Factors for Systemic Inflammatory Response After Congenital Cardiac Surgery.
Güvener M1, Korun O, Demirtürk OS.
This study aims to assess the frequency of systemic inflammatory response syndrome (SIRS) following congenital heart surgery and risk factors associated with this clinical syndrome.
Charts of all patients undergoing surgery for congenital heart disease in a single institution over a five-year period were analyzed retrospectively. The presence of SIRS was evaluated based on the criteria of the International Pediatric Sepsis Consensus Conference.
Of the 246 patients included in the study 22 (8.9%) had clinical parameters indicating SIRS. The patients in the SIRS group had significantly longer cardiopulmonary bypass time (105.14 ± 27.27 vs. 66.86 ± 26.64 min; p