Protect your patient’s kidneys
Rhabdomyolysis results in release of myoglobin into the bloodstream. Excessive myoglobin can accumulate in the kidneys and lead to acute kidney injury (AKI).
CytoSorb in severe rhabdomyolysis
CytoSorb® hemoadsorption goes beyond renal replacement therapies – it can help support the recovery of kidney function when conventional strategies to remove myoglobin alone prove ineffective.
Hyperinflammation caused by rhabdomyolysis can aggravate AKI and should also be addressed. Early protection of the kidneys helps improve the patient’s prognosis, and early myoglobin clearance may even help prevent AKI.
CytoSorb is a unique technology that’s proven to effectively, safely and simultaneously reduce both elevated levels of cytokines and myoglobin, thereby supporting the recovery of renal function.
CytoSorb can be used to address important challenges in severe rhabdomyolysis
Manage rhabdomyolysis
CytoSorb has been shown to effectively and safely remove elevated levels of myoglobin, while additionally addressing any concomitant hyperinflammation, helping in the management of rhabdomyolysis.
Rhabdomyolysis can cause serious damage:
Rapid breakdown of the skeletal muscles
Myoglobin released into the bloodstream
Myoglobin accumulates in renal tubules
Excessive myoglobin levels may result in:
- Oxidative stress
- Inflammatory response
- Endothelial dysfunction
- Renal vasoconstriction
- Apoptosis
- Cellular and granular casts
AKI – Acute Kidney Injury
-
Rapid breakdown of the skeletal muscles
-
Myoglobin released into the bloodstream
-
Myoglobin accumulates in renal tubules
-
Excessive myoglobin levels may result in:
- Oxidative stress
- Inflammatory response
- Endothelial dysfunction
- Renal vasoconstriction
- Apoptosis
- Cellular and granular casts
-
AKI – Acute Kidney Injury
By removal of elevated myoglobin, CytoSorb Therapy can help to restore kidney function:
Best practice therapy management
-
Patient selection
- Confirmed/ suspected rhabdomyolysis with impending/existing acute kidney injury (AKI)
- Myoglobin levels > 10,000 µg/L
- Contraindication for intensified fluid therapy
-
Timing
- Ideally start within the first 24 hours after diagnosis/onset of severe rhabdomyolysis
- In general start early before irreversible damage occurs < 12 hours after diagnosis/start of standard therapy
-
Dosing
- Consider changing adsorber
after 8 hours until sufficient
stabilization/clinical
improvement has occurred or
myoglobin levels well below
5000 µg/L have been reached.
- Consider changing adsorber
Additional Information
- Albrecht et al., Blood Purif 2024; 53(2):88-95
- Grafe et al., Ren Fail 2023; 45(2):2259231
- Scharf et al., Crit Care 2021; 25(1):41
- Chavez et al., Crit Care 2016; 20(1):135
- Boutaud et al., Proc Natl Acad Sci USA 2010; 107(6):2699-704
- Bosch et al., N Engl J Med 2009; 361(1):62-72
- Khan et al., Neth J Med 2009; 67(9):272-283
- Chatzizisis et al., Eur J Intern Med 2008; 19(8):568-574
Voices around the world
Dr. Filipo Aucella
Italy, San GiovanniWhen we started to use CytoSorb®, we were very impressed by the rapid decrease of myoglobin concentrations, and the renal damage also improved very rapidly.
Dr. Maria Grazia Calabro
Italy, MilanCytoSorb is effective in reducing bilirubin, creatinine, and lactate in patients who are critically ill, mainly due to cardiogenic shock.
Dr. Tobias Hübner
Switzerland, MünsterlingenThe reason for us to use CytoSorb in the ICU was the lack of treatment options. We never had anything in sepsis, and CytoSorb® is the new star on the horizon.
Dr. Gabriella Bottari
Italy, RomeWe have applied CytoSorb in critical ill children with septic shock, with very good results.
Dr. Mihai Popescu
Romania, BucharestOur results show a potential benefit of CytoSorb in rebalancing liver function in patients with liver failure compared to MARS.
Dr. Serdar Gunaydin
Turkey, AnkaraOne of the most important indications for us to use CytoSorb® in is cardiac surgery, as it has also been cited in many guidelines.
Dr. Willem Pieter Brouwer
The Netherlands, RotterdamIntervention with CytoSorb may be associated with decreased all-cause mortality at 28 days compared to continuous renal replacement therapy alone.
Prof. Jean Louis Vincent
Belgium, BrusselsI would like to send my congratulations on the 10th anniversary of CytoSorb®. It is great how you have created a new way of blood purification therapy.
Juan Carlos Ruiz-Rodriguez
Spain, BarcelonaThis case highlights that cytokine hemoadsorption can lead to a rapid decrease in IL-10 levels, and significant hemodynamic improvement was achieved.
Dr. Gabriella Bottari
Italy, RomeHemoperfusion with CytoSorb in combination with continuous kidney renal therapy is a valuable therapeutic option in sepsis-associated acute kidney injury.
Dr. Askhat Saparov
Kazakhstan, AstanaCytoSorb was safe and well-tolerated in a pediatric patient and has proven its value as an adjuvant therapy for sepsis in pediatric patient populations.
Prof. Peter Pickkers
The Netherlands, NijmeganThe treatment with the CytoSorb® adsorber does reduce circulating concentrations at day one.
Dr. Abdulrahman Alharthy
Saudi Arabia, RiyadhIn this retrospective case series, CRRT with CytoSorb provided a safe rescue therapy in COVID-19 with associated AKI, ARDS, sepsis, and hyperinflammation.
Dr. Kai Singbartl
USA, PhoenixThe case represents the first successful application of CytoSorb in severe refractory neurotoxicity following treatment with chimeric-antigen-receptor T cells.
Dr. Henriette Roed-Undlien
Norway, OsloIn this in vitro study, apixaban levels were effectively reduced, and the clotting time and thrombin generation assays were normalized by the use of CytoSorb.
Dr. Aleksandr Burov
Russia, MoskowThis case series demonstrates that combined blood purification therapy including CytoSorb may have a role for septic shock patients with primary brain injury.
Prof. JW Awori Hayanga
USA, MorgantownIn COVID-19 ARDS on VV-ECMO + hemoadsorption, 90-day survival 74% and early intervention associated with shorter organ support, supporting “enhanced lung rest”.
Dr. Haider Ghaidan
Sweden, LundCytoSorb restored lung function and reduced PGD in lung transplantation. We suggest this treatment will increase tolerability of donor lungs in recipients.
Dr. Pawel Piwowarczyk
Poland, LublinCytoSorb Therapy was able to facilitate long-term regain of balance between inflammatory process, cytokine production, and bilirubin turnover in the liver.
Dr. Anna Krakowiak
Poland, LodzIn the event of poisoning with inorganic mercury compounds, CRRT using CytoSorb as an extracorporeal blood purification method may be considered.
Dr. Vanja Persic
Slovenia, LjubljanaUse of CytoSorb in shocked SIRS patients was associated with rapid IL-6 decrease and hemodynamic improvement, with improved observed vs predicted survival.
Dr. Simao Rodeia
Portugal, LisbonCytokine adsorption therapy with CytoSorb was employed with no direct complications, and helped control the inflammatory state.
Dr. Christopher Rugg
Austria, InnsbruckCatecholamines decreased within 24 h after initiation of CytoSorb Therapy; in-hospital mortality was significantly lower in the CytoSorb group (35.7% vs 61.9%).
Perfusionist Anna Holmen
Sweden, GothenburgThe accumulated norepi dose in the CytoSorb gp was half or less at all postop time points compared to controls..with significantly lower need for RBC.
Assoc. Prof. Berna Kaya Ugur
Turkey, GaziantepUse of CytoSorb achieved significant decreases in endocan, copeptin, IL-6, procalcitonin and C-reactive protein levels.
Dr. John Ferdinand
UK, CambridgeOur data suggest that adsorption of pro-inflammatory mediators from perfusate with CytoSorb represents potential intervention which may improve organ viability.
Prof. Dana Tomescu
Romania, BucharestThe use of CytoSorb in patients with severe acute pancreatitis was associated with improved hemodynamics and decreased inflammatory markers.
Dr. Arosha Minori Gunasekera
Sri Lanka, ColomboThis patient with acute liver failure was managed successfully with supportive therapy, aided by CytoSorb hemoadsorption and therapeutic plasma exchange.
Dr. Endre Nemeth
Hungary, BudapestIntraoperative hemoadsorption associated with better hemodynamics, lower post-op AKI and RRT, stable bilirubin, and shorter mechanical ventilation time and ICU
Dr. Fatime Hawchar
Hungary, SzegedThe first trial to investigate the effects of early extracorporeal cytokine adsorption treatment in septic shock applied without renal replacement therapy.
Dr. Wun Fung Hui
Hong Kong, Hong KongHemoadsorption with CytoSorb can be considered as an adjunctive therapy for children with severe rhabdomyolysis-associated acute kidney injury.
Dr. Maroua Eid
France, AngersThis case describes the successful use of CytoSorb with CRRT and extracorporeal life support in a combined way to overcome a critical phase of septic shock.
Dr. Marine Peyneau
France, ParisCytoSorb appears to be safe and promising to fight post-lung transplantation inflammation, and should be re-evaluated in a larger study.
Dr. Daniel Lovric
Croatia, ZagrebThis is the first study showing an increase in urinary output and a trend towards better survival among patients on VA ECMO treated with CytoSorb.
Prof. Pedja Kovacevic
Bosnia and Herzegovina, Banja LukaThis case series describes potential positive effects of hemoadsorption in preventing the development of systemic hyperinflammation after vvECMO in ARDS.
Certified Clinical Perfusionist Martin Clerici
Argentina, Buenos AiresIntraoperative use of CytoSorb® in an endocarditis patient with extensive cardiovascular history was associated with improvements in the hemodynamic situation.
Prof. Dorel Sandec
Romania, TimisoaraWe treated more than 75 patients with CytoSorb® because we realized, we feel, we see, we measure a significant effect on the evolution of the patient.
Dr. Voyka Gorjup
Slovenia, LjubljanaThe most prominent clinical effect is the lowering of vasopressors, hemodynamic stability, lowering of interleukins and in those patients who are on vvECMO…
Dr. Candido Amador
Panama, Panama CityIn my experience the vasopressor doses decreased, biomarkers of sepsis (…) and the inflammatory response as well as multiple organ function improved.
Assoc. Prof. Monir Sadat Hakemi
Iran, TehranIt seems that applying the CytoSorb in combination with CRRT in ICU septic patients with AKI is correlated with a significant decrease in mortality.
Dr. Yatin Mehta
India, GurgaonCytoSorb is indicated for use in conditions where elevated levels of cytokine and/or bilirubin and/or myoglobin exist.
Dr. L. Christian Napp
Germany, HannoverIn the most critically ill patients on ECMO support, we observed a drop in catecholamine demand and an improvement in clinical state on ECMO.
Prof. Steffen Mitzner
Germany, RostockWhat strikes you first is that you can stabilize patients in septic shock.
Access Healthcare Professionals Area
This area is for Health Care Professionals only and provides reports about clinical experiences gained during the use of CytoSorbents products. The information presented reflects the opinions and procedural techniques of individual physicians and is not intended as medical advice. Physician experience, risks, patient outcomes and results may vary.