Adsorbtion of Cytokines Early in Septic Shock: the ACESS Study

The Effect of Early Cytokine Absorption on the Systemic Inflammatory Response Syndrome and Organ Dysfunction in the First 48 Hours of Septic Shock

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.

Inclusion Criteria:

• Signs of hypoperfusion: serum lactate >2 mmol/L, low central venous oxygen saturation (ScvO2) (<70%) or high ScvO2 (>85%), metabolic acidosis, oligo-anuria, high venous-to-arterial CO2-gap (dCO2 >6 mm Hg)
• Hemodynamic support with vasopressors
• Procalcitonin level ≥ 3 ng/ml
• Invasive hemodynamic monitoring
• Written informed content

Exclusion Criteria:

• Patients under 18 years
• Pregnancy (bHCG test positivity)
• Surgical intervention in context with the septic insult
• New York Heart Association IV heart failure
• Acute coronary syndrome
• Need for acute or chronic hemodialysis
• Acute haematological malignancies
• Cardiogenic shock
• Post cardiopulmonary resuscitation care
• Immunosuppression, systemic steroid therapy (>10mg prednisolon/day)
• Human immunodeficiency virus infection (HIV) and active AIDS
• Patients with donated organs
• Thrombocytopenia (<20.000/ml)
• More than 10%-of body surface area with third degree burn