The progresses in extracorporeal life support technology have brought new options for the treatment of critical illnesses. The extracorporeal life support technology of extracorporeal membrane oxygenation (ECMO) has significantly increased survival rate of the patients. However, ECMO may also have problems, such as organ damage caused by the inflammatory cytokine storm. The presence of extracorporeal life support with adsorption technology (ECLSA) may overcome these problems. ECLSA combines blood perfusion and extracorporeal life support technology to remove harmful substances such as inflammatory mediators, thus improving inflammation response and enhancing survival rate of the patients. ECLSA shows great potential in the treatment of critical illnesses. This article provides an overview of the progresses in the clinical application of ECLSA.
[1] Le Gall A, Follin A, Cholley B, et al. Veno-Arterial-ECMO in the Intensive Care Unit:From Technical Aspects to Clinical Practice[J]. Anaesth Crit Care Pain Med. 2018;37(3):259-268.
[2] Elbayomi M, Steger K, Heim C，et al. (1300) - Cytokine Storm Alleviated Using a Haemofilter in Veno-Venous Extracorporeal Membrane Oxygenation[J]. Journal of Heart and Lung Transplantation, 2024, 43(4):S601-S601.
[3] Lebreton G, Dorgham K, Quentric P, et al. Longitudinal Cytokine Profiling in Severe COVID-19 Patients on ECMO and Haemoadsorption[J]. American Journal of Respiratory and Critical Care Medicine, 2021, 203(11).
[4] Napp LC, Ziegeler S, Kindgen-Milles DJBP. Rationale of Hemoadsorption during Extracorporeal Membrane Oxygenation Support[J]. Blood Purif. 2019;48(3):203-214
[5] Buscher H. Extracorporeal Life Support: The ELSO Red Book Red Book 5th Edition ISBN 978-0-9656756-5-9Weaning and Decannulation of Adults with Respiratory Failure on ECLS: Extracorporeal Life Support: The ELSO Red Book Red Book 5th Edition; 2020.
[6] Wrisinger WC, Thompson SL. Basics of Extracorporeal Membrane Oxygenation[J]. Surgical Clinics of North America. 2022;102(1):23-35.
[7] Bartlett RH, Roloff DW, Cornell RG, et al. Extracorporeal circulation in neonatal respiratory failure: a prospective randomized study. Pediatrics. 1985;76(4):479-487.
[8] Thiagarajan RR, Barbaro RP, Rycus PT,, et al. Extracorporeal Life Support Organization Registry International Report 2016[J]. ASAIO J. 2017;63(1):60-67.
[9] Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure[J]. Kardiol Pol. 2016;74(10):1037-1147.
[10] Chen Q, Yu W, Shi J, et al. The effect of venovenous extra-corporeal membrane oxygenation (ECMO) therapy on immune inflammatory response of cerebral tissues in porcine model[J]. J Cardiothorac Surg. 2013;8:186.
[11] Millar JE, Fanning JP, Mcdonald CI,et al. The inflammatory response to extracorporeal membrane oxygenation (ECMO): a review of the pathophysiology[J]. Crit Care. 2016;20(1):387.
[12] Rimmer EK, Houston BL, Kumar A, et al. The Efficacy and Safety Of Therapeutic Aheresis In Sepsis and Septic Shock: A Systematic Review and Meta-Analysis[J]. Shock. 2023;60(6):746-752.
[13] Patcharin S, Rujipat S, Kanokwan S, et al. Polymyxin B Hemoperfusion in Pediatric Septic Shock: Single-Center Observational Case Series[J]. Pediatr Crit Care Med. 2022;23(8):e386-e391.
[14] Thomas R, Abdulnasser A, Mathilde C, et al. High-volume haemofiltration with a new haemofiltration membrane having enhanced adsorption properties in septic pigs[J]. Nephrol Dial Transplant. 2009;24(2):421-427.
[15] Slagman AC, Bock C, Abdel AH, et al. Specific removal of C-reactive protein by apheresis in a porcine cardiac infarction model[J]. Blood Purif. 2011;31(1-3):9-17.
[16] Hinz B, Jauch O, Noky T, et al. CytoSorb, a Novel Therapeutic Approach for Patients with Septic Shock: A Case Report[J]. Int J Artif Organs. 2015;38(8):461-464.
[17] Ramirez-Guerrero G, Torres Cifuentes V, Baghetti Hernandez R, et al. Early Cytokine Removal in Critical COVID-19 Patients with Extracorporeal Therapies (HA-380 plus High Volume Hemofiltration) May Prevent Progression of Acute Respiratory Distress Syndrome: Case Report[J]. Blood Purif. 2021;50(4-5):575-577.
[18] Onuk S, Akin AK, Sari A, et al. The Clinical and Laboratory Efficacy of HA 330 Treatment Combined with Continuous Renal Replacement Therapy in Septic Shock Patients: A Case Series[J]. Blood Purif. 2023;52(2):140-147.
[19] Montazersaheb S, Khatibi SMH, Hejazi MS, et al. COVID-19 infection: an overview on cytokine storm and related interventions[J]. Virol J. 2022;19(1):92.
[20] Han S, Mallampalli RKJJoI. Correction: The Acute Respiratory Distress Syndrome: From Mechanism to Translation[J]. J Immunol. 2015;194(11):5569.
[21] Thiagarajan RR, Barbaro RP, Rycus PT, et al. Extracorporeal Life Support Organization Registry International Report 2016. ASAIO J. 2017;63(1):60-67.
[22] Rieder M, Duerschmied D, Zahn T, et al. Cytokine Adsorption in Severe Acute Respiratory Failure Requiring Veno-Venous Extracorporeal Membrane Oxygenation[J].ASAIO J. 2021;67(3):332-338.
[23] Akil A, Napp LC, Rao C, et al. Use of CytoSorb? Hemoadsorption in Patients on Veno-Venous ECMO Support for Severe Acute Respiratory Distress Syndrome: A Systematic Review[J]. Journal of Clinical Medicine. 2022;11(20) :5990.
[24] Akil A, Ziegeler S, Reichelt J, et al. Combined Use of CytoSorb and ECMO in Patients with Severe Pneumogenic Sepsis[J]. Thorac Cardiovasc Surg. 2021;69(3):246-251.
[25] Kogelmann K, Scheller M, Drüner M, et al. Use of hemoadsorption in sepsis-associated ECMO-dependent severe ARDS: A case series[J]. J Intensive Care Soc. 2020;21(2):183-190.
[26] Hayanga JWA, Song T, Durham L, et al. Extracorporeal hemoadsorption in critically ill COVID-19 patients on VV ECMO: the CytoSorb therapy in COVID-19 (CTC) registry[J]. Crit Care. 2023;27(1):243.
[27] Giordano G, Alessandri F, Pugliese FJC. Hemoperfusion during veno-venous ECMO in severe COVID-19 with IL-6 elevation[J]. Cytokine. 2022;152:155813.
[28] David S, Thamm K, Schmidt BMW, et al. Effect of extracorporeal cytokine removal on vascular barrier function in a septic shock patient[J]. J Intensive Care. 2017;5:12.
[29] Punsmann S, Hoppe J, Klopfleisch R, et al. Acute interstitial pneumonia in foals: A severe, multifactorial syndrome with lung tissue recovery in surviving foals[J]. Equine Vet J. 2021;53(4):718-726.
[30] Lee SI. Effectiveness of polymyxin B hemoperfusion in acute exacerbation of interstitial pneumonia: a retrospective analysis. Sarcoidosis Vasc Diffuse Lung Dis. 2021;38(1):e2021012.
[31] Junji I, Shinichiro O, Yoshiko K, et al. A pilot study: a combined therapy using polymyxin-B hemoperfusion and extracorporeal membrane oxygenation for acute exacerbation of interstitial pneumonia[J]. Sarcoidosis Vasc Diffuse Lung Dis. 2015;31(4):343-349.
[32] Lovri? D, Pa?ali? M, Kri?anac S, et al. The addition of Cytosorb in patients on VA‐ECMO improves urinary output and ICU survival[J]. Therapeutic Apheresis and Dialysis. 2023;28(1):103-11.
[33] Dogan G, Hanke J, Puntigam J, et al. Hemoadsorption in cardiac shock with bi ventricular failure and giant-cell myocarditis:A case report[J]. Int J Artif Organs. 2018;41(8):474-479.
[34] Lesbekov T, Nurmykhametova Z, Kaliyev R, et al. Hemadsorption in patients requiring V-A ECMO support: Comparison of Cytosorb versus Jafron HA330[J]. Artif Organs. 2023;47(4):721-730.
[35] Zickler D, Nee J, Arnold T, et al. Use of Hemoadsorption in Patients With Severe Intoxication Requiring Extracorporeal Cardiopulmonary Support—A Case Series[J]. ASAIO J. 2021;67(11):e186-e190.
[36] Enkhbaatar P, Pruitt BA Jr, Suman O, et al. Pathophysiology, research challenges, and clinical management of smoke inhalation injury. Lancet. 2016;388(10052):1437-1446.
[37] Jang JH, Jang HJ, Kim HK, et al. Acute respiratory distress syndrome caused by carbon monoxide poisoning and inhalation injury recovered after extracorporeal membrane oxygenation along with direct hemoperfusion with polymyxin B-immobilized fiber column: a case report[J]. J Med Case Rep. 2021;15(1):456.
[38] Stanjek-Cichoracka A, Wo?niak-Grygiel E, ?aszewska A, et al. Interleukin 6 and Interleukin 10 in Patients Before and After Lung Transplantation[J]. Transplantation proceedings. 2020;52(7):2098-100.
[39] Peyneau M, de Chaisemartin L, Faille D, et al. First Experience With Extracorporeal Cytokine Adsorption Therapy After Lung Transplantation[J]. Transpl Int. 2022;35:10319.
