{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T19:48:03Z","timestamp":1789760883917,"version":"4.0.1"},"reference-count":47,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T00:00:00Z","timestamp":1628726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Hemadsorption via the cytokine\u2010adsorber CytoSorb (CytoSorbents Europe, Berlin, Germany) has successfully been used as an adjunctive method in adults, mainly for the purpose of immunomodulation under acute inflammatory conditions such as sepsis and cardiac surgery. In recent years, there has been growing interest in its use in pediatric intensive care to improve outcomes in patients with multiple organ failure following an inflammatory illness. Literature on the application of CytoSorb in neonatal and pediatric patients is scarce, though the implication is that it could be an effective last\u2010resort treatment option in critically ill pediatric patients. Herein we present the clinical cases of two pediatric patients successfully treated with a combination of the CytoSorb hemadsorber, continuous renal replacement therapy, and extracorporeal membrane oxygenation due to multiple organ failure following different underlying medical conditions. Patient 1 was a 7\u2010month\u2010old male child with Down's syndrome admitted to the Pediatric Intensive Care Unit (PICU) after congenital heart surgery, who developed antimicrobial\u2010resistant septic shock and severe acute respiratory distress syndrome. Patient 2 was a 2\u2010year\u2010old male child admitted to the PICU with influenza A\u2010associated acute liver failure resulting in hyperammonemia, lactate acidosis, hemodynamic instability, and acute kidney failure. In both patients, hemadsorption with CytoSorb was initiated as an adjunctive rescue therapy to treat refractory multisystem organ failure. Improvement of laboratory and clinical parameters was observed within hours of treatment initiation. The application of the hemadsorber\u2014developed for use in adults\u2014proved simple and safe for use in both of our low\u2010weight pediatric patients.<\/jats:p>","DOI":"10.1111\/aor.14047","type":"journal-article","created":{"date-parts":[[2021,7,31]],"date-time":"2021-07-31T17:26:42Z","timestamp":1627752402000},"page":"1582-1593","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Hemadsorption as rescue therapy for patients with multisystem organ failure in pediatric intensive care\u2014Report of two cases reports and review of the literature"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8665-2127","authenticated-orcid":false,"given":"Lisa\u2010Maria","family":"Steurer","sequence":"first","affiliation":[{"name":"Division of Neonatology Pediatric Intensive Care &amp; Neuropediatrics Department of Pediatric and Adolescent Medicine Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald","family":"Schlager","sequence":"additional","affiliation":[{"name":"Division of Neonatology Pediatric Intensive Care &amp; Neuropediatrics Department of Pediatric and Adolescent Medicine Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kambis","family":"Sadeghi","sequence":"additional","affiliation":[{"name":"Division of Neonatology Pediatric Intensive Care &amp; Neuropediatrics Department of Pediatric and Adolescent Medicine Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann","family":"Golej","sequence":"additional","affiliation":[{"name":"Division of Neonatology Pediatric Intensive Care &amp; Neuropediatrics Department of Pediatric and Adolescent Medicine Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Wiedemann","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hermon","sequence":"additional","affiliation":[{"name":"Division of Neonatology Pediatric Intensive Care &amp; Neuropediatrics Department of Pediatric and Adolescent Medicine Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000500013"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-019-0530-y"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2017.10.128"},{"key":"e_1_2_8_5_1","unstructured":"CytoSorbents Europe[Internet].Berlin:Der Adsorber; c2021 [cited 2021 Jan 31]. Available from:https:\/\/cytosorb\u2010therapy.com\/de\/der\u2010adsorber\/"},{"key":"e_1_2_8_6_1","unstructured":"CytoSorbents Europe[Internet].Berlin:Fields of Application; c2021 [cited 2021 Jan 31]. Available from:https:\/\/cytosorb\u2010therapy.com\/en\/the\u2010therapy\/fields\u2010of\u2010application\/"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e318170b9a7"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000000439"},{"key":"e_1_2_8_9_1","unstructured":"CytoSorbents Europe[Internet].Berlin:Die Studien; c2021 [cited 2021 Jan 31]. Available from:https:\/\/cytosorb\u2010therapy.com\/de\/die\u2010studien\/"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.5301\/ijao.5000591"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000432"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2017.2352"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.103.2.565"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1086\/315214"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1208623"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1594.2003.07289.x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.15.1655"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1600818"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hbpd.2019.07.003"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-020-00795-0"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0000000000000953"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00063-017-0342-5"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.5492\/wjccm.v10.i1.22"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0187015"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1159\/000111568"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1159\/000369377"},{"issue":"1","key":"e_1_2_8_28_1","first-page":"82","article-title":"Early cytokine adsorption in septic shock (ACESS\u2010trial): results of a proof concept, pilot study","volume":"22","author":"Oeveges N","year":"2018","journal-title":"Crit Care"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2018.11.003"},{"key":"e_1_2_8_30_1","volume-title":"CytoSorb\u00ae emergency use authorization for use in patients with COVID\u201019 infection","author":"US Food and Drug Administration","year":"2020"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(21)00177-6"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/0391398820902469"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.11648\/j.ajp.20190502.11"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/0391398819837539"},{"key":"e_1_2_8_35_1","first-page":"6987167","article-title":"Hemadsorption with adult CytoSorb\u00ae in a low weight pediatric case","volume":"2017","author":"Cirstoveanu CG","year":"2017","journal-title":"Case Rep Crit Care"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/0391398818819953"},{"key":"e_1_2_8_37_1","first-page":"3818407","article-title":"Use of hemadsorption in a case of pediatric toxic shock syndrome","volume":"2017","author":"Berkes A","year":"2017","journal-title":"Case Rep Crit Care"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/0391398819858174"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13312-019-1661-9"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCE.0000000000000071"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.676298"},{"key":"e_1_2_8_42_1","unstructured":"CytoSorbents Europe[Internet].Berlin:Technische Daten des Adsorbers; c2021 [cited 2021 Jan 31]. Available from:https:\/\/cytosorb\u2010therapy.com\/de\/der\u2010adsorber\/technische\u2010daten\u2010des\u2010cytosorb\u2010adsorber\/"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-017-1662-9"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1159\/000492379"},{"key":"e_1_2_8_45_1","unstructured":"CytoSorbents Europe[Internet].Berlin:Die Therapie; c2021 [cited 2021 Jan 31]. Available from:https:\/\/cytosorb\u2010therapy.com\/de\/die\u2010therapie\/therapieeffekte\/"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1177\/1751143715574855"},{"key":"e_1_2_8_47_1","volume-title":"CytoSorbTM 300 mL device\u2014instructions for use","author":"CytoSorbents Inc","year":"2012"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.23736\/S0375-9393.19.13189-6"}],"container-title":["Artificial Organs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aor.14047","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aor.14047","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aor.14047","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T03:20:31Z","timestamp":1692847231000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aor.14047"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,12]]},"references-count":47,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1111\/aor.14047"],"URL":"https:\/\/doi.org\/10.1111\/aor.14047","archive":["Portico"],"relation":{},"ISSN":["0160-564X","1525-1594"],"issn-type":[{"value":"0160-564X","type":"print"},{"value":"1525-1594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,12]]},"assertion":[{"value":"2021-03-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}