EuroELSO 2019 CytoSorbents was a major sponsor at the 8th EuroELSO 2019 Congress held recently in Barcelona, Spain that brought together more than 1,500 intensivists, cardiac surgeons, cardiologists, pediatric and neonatology specialists, perfusionists, and ICU nurses from around the world, to obtain vital updates in the use of extracorporeal membrane oxygenation (ECMO) and other extracorporeal support technologies to help treat critically ill patients.
Dr. Bartlett commented, "The combination of ECMO and systemic inflammatory mediator reduction with CytoSorb has the potential to be an exciting new innovation in treating lung injury, shock and other complications. The data combining the two therapies are very encouraging, especially in sepsis. I look forward to seeing the story strengthen as we gain greater clinical experience."
CytoSorbents offered a two-day live presentation workshop during the conference, which was attended by approximately 100 medical specialists and led by top perfusionists from Switzerland and Italy with experts from CytoSorbents, to discuss and demonstrate the use of ECMO and CytoSorb as a life-saving therapy.
Welcome address – Prof. Jean-Louis Vincent, Chairman of the ISICEM, Brussels, Belgium
Opening lecture: Past, present and future of CytoSorb – Prof. Claudio Ronco, Vicenza, Italy
Speakers and panel discussions
From experiments to evidence Chairs: Prof. John Kellum, Pittsburgh, USA& Prof. Didier Payen, Paris, France
CytoSorb and shock reversal Chairs: Prof. Zsolt Molnar, Szeged, Hungary & Prof. Manu Malbrain, Brussels, Belgium
CytoSorb in various fields of application Chairs: Prof. Claus Krenn, Vienna, Austria & Prof. Michael Bauer, Jena, Germany
Some of the highlighted topics and presentations included:
CytoSorb as an Immunomodulating Therapy: Prof. Claudio Ronco, St. Bortolo Hospital, Vicenza, Italy summarized the current knowledge supporting the use of CytoSorb to treat sepsis, including its role in reducing inflammation, cytokines, toxins, capillary leak syndrome, and restoring immune homeostasis. He concluded that the treatment of sepsis may benefit from a combined therapeutic approach involving antibiotics and various blood purification technologies, including CytoSorb.
Reversal of Septic Shock: Dr. Yatin Mehta, Delhi, India, presented data supporting the use of CytoSorb to improve hemodynamic stability and reduce vasopressor usage in a large cohort of 100 septic shock patients from India, especially when the therapy was started within the first 48 hours after the development of septic shock.
Post-Cardiac Arrest Resuscitation: eCPR (extracorporeal cardio-pulmonary resuscitation with veno-arterial extra-corporeal membrane oxygenation or VA-ECMO) is a vitally important new innovation to restore blood flow in patients whose hearts suddenly stop and often die. However, even when blood flow is restored, massive inflammation and cytokine storm can destabilize and potentially kill the patient. Prof. Daniel Dürschmied, Freiburg-Bad Krozingen, Germany presented data on the first 25 patients treated with both CytoSorb and eCPR at his institution, demonstrating a more than doubling of survival compared to that predicted. Setup was easy, there were no severe complications, and there was a rapid decrease in IL-6 and lactate. He also announced the start of a new 30-patient randomized controlled pilot study evaluating eCPR with or without CytoSorb.
Transplant Organ Rehabilitation:Dr. Ilker Iskender, Zurich, Switzerland demonstrated that cytokine reduction with CytoSorb in an ex vivo porcine lung perfusion model improved lung function and decreased pulmonary edema and electrolyte imbalances, supporting a potential role of the therapy in lung and other organ transplant.
Necrotizing Fasciitis: Prof. Didier Payen, Paris, France emphasized the ability of CytoSorb to reduce a wide spectrum of cytokines, bacterial toxins, and other damage and pathogen associated inflammatory mediators, and how this could be beneficial in treating necrotizing fasciitis (commonly referred to as "flesh eating bacterial infection") and soft tissue infections caused by toxin-producing Staphylococcus and Streptococcus bacteria.
International CytoSorb Registry Update:Prof. Frank Brunkhorst, Jena, Germany, provided an update on the 7th interim analysis of the International CytoSorb Registry covering 599 patients, of which 348 patients had sepsis or septic shock. Among these patients, CytoSorb use showed a decrease in observed mortality vs expected mortality amongst very sick patients, while those treated less than 12 hours after the diagnosis of septic shock had a higher survival rate than those treated after 12 hours.
Effect on Coagulation Factors and Antibiotics:Dr. Antoine Schneider, Lausanne, Switzerland, presented data from a 30-patient randomized controlled pilot study in cardiac surgery, showing no significant change in the levels of the vast majority of coagulation factors – supporting the safety of CytoSorb during cardiac surgery. In addition, he presented important new experimental porcine data suggesting that the removal of a number of key antibiotics by CytoSorb was small compared to control pigs, and could be mitigated by increasing the antibiotic dose, further supporting the safety of CytoSorb in septic patients.
Microcirculation:Prof. Can Ince, Amsterdam, Netherlands discussed the available data supporting the benefit of CytoSorb in improving microcirculation, a key factor in protecting and restoring organ function, and announced the initiation of a new trial to evaluate this.
Risk Stratification CytoScoreTM:Dr. Klaus Kogelmann, Emden, Germany introduced a new risk stratification algorithm based on vasopressor use, and clinical and laboratory data, called the CytoScore™, designed to help clinicians decide when to start CytoSorb therapy and how long to continue treatment. He again reiterated the need to begin treatment early.
Liver Failure:Prof. Dana Tomescu, Bucharest, Romania discussed her experience in using CytoSorb to treat acute exacerbations of chronic liver failure triggered by infection, with significant reductions in bilirubin and without bleeding complications.
Rhabdomyolysis: Prof. Jacques Duranteau, Paris, Francereviewed how high levels of myoglobin released by damaged muscle following severe trauma can lead rapidly to acute kidney injury, and how CytoSorb is used to help prevent this.
Extracorporeal Membrane Oxygenation (ECMO): Prof. Federico Pappalardo, Milan, Italyrecommended consideration of CytoSorb as a primary adjunct to ECMO therapy to help stabilize patients, particular those suffering from shock, hyperinflammation, and hemolysis generated by ECMO.
Children: Dr. Andrey Rybalko, Moscow, Russiacited numerous successes when CytoSorb was used in adolescents and young children. He also presented two cases when CytoSorb was used on infants between 10-20 pounds, to treat acute liver failure, and to treat multiple organ failure and hemolysis during ECMO following a complicated post-operative recovery from heart surgery.
Sepsis and Chronic Lupus: Dr. Axel Nierhaus, Hamburg, Germany presented a special case of a young woman with a long history of a serious autoimmune disease called lupus, on chronic immune suppression, who was admitted with septic shock and multiple organ failure due to an E. coli soft tissue groin and thigh infection. She was successfully treated with aggressive use of CytoSorb, and was again successfully treated with CytoSorb following a bout of Klebsiella pneumonia a week later, leading to her full recovery.
CytoSorbents also was a Platinum Sponsor and Exhibitor at ISICEM, and hosted a Satellite Symposium that attracted approximately 450 attendees from 25 countries, with the following agenda:
"Update on the Role of CytoSorb Hemoadsorption in Intensive Care and Emergency Medicine"
Chairs: Prof. Lui Forni, Surrey, UK and Prof. Claus Krenn, Vienna, Austria
Rationale for hemoadsorption and review of latest scientific results Prof. Herwig Gerlach, Berlin, Germany
Impact on microvascular perfusion in septic shock Prof. Abele Donati, Ancona, Italy
Combination of ECMO with CytoSorb – Chances to improve outcome Prof. Daniel Dürschmied, Freiburg, Germany
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About CytoSorbents Corporation (NASDAQ: CTSO) CytoSorbents Corporation is a leader in critical care immunotherapy, specializing in blood purification. Its flagship product, CytoSorb® is approved in the European Union with distribution in 55 countries around the world, as an extracorporeal cytokine adsorber designed to reduce the "cytokine storm" or "cytokine release syndrome" that could otherwise cause massive inflammation, organ failure and death in common critical illnesses. These are conditions where the risk of death is extremely high, yet no effective treatments exist. CytoSorb® is also being used during and after cardiac surgery to remove inflammatory mediators that can lead to post-operative complications, including multiple organ failure. CytoSorbents is conducting its pivotal REFRESH 2-AKI trial – a multi-center, randomized controlled, clinical trial intended to support U.S. regulatory approval of CytoSorb for use in a heart-lung machine during complex cardiac surgery to reduce organ injury. CytoSorb® has been used in more than 56,000 human treatments to date.
CytoSorbents' purification technologies are based on biocompatible, highly porous polymer beads that can actively remove toxic substances from blood and other bodily fluids by pore capture and surface adsorption. Its technologies have received non-dilutive grant, contract, and other funding of nearly $26 million from DARPA, the U.S. Army, the U.S. Department of Health and Human Services, the National Institutes of Health (NIH), National Heart, Lung, and Blood Institute (NHLBI), U.S. Special Operations Command (USSOCOM), and others. The Company has numerous products under development based upon this unique patented blood purification technology including CytoSorb-XL™, HemoDefend™, VetResQ™, K+ontrol™, ContrastSorb, DrugSorb, and others. For more information, please visit the Company's websites at www.cytosorbents.com and www.cytosorb.com and follow us on Facebook and Twitter.
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