{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:03:33Z","timestamp":1792757013732,"version":"4.5.0"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:00:00Z","timestamp":1760054400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hemoadsorption with CytoSorb is a novel treatment for cytokine release syndrome, but there are few published data on the rate of cytokine removal with prolonged use. Here, we report a prospective observational study of IL-6 extraction ratios with prolonged CytoSorb use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A secondary analysis was conducted on a prospective observational cohort study involving patients treated with CytoSorb. Blood samples for IL-6 were taken before treatment, after 30\u202fmin, and every 6\u202fh of treatment at three sites: (1) before the adsorber, (2) between the adsorber and dialyzer, and (3) after the dialyzer. The extraction ratios of the adsorber were then calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 21 dialysis circuits performed in 15 critically ill patients, mainly those with cytokine storm because of septic shock. The median extraction ratio of IL-6 after 30\u202fmin was 26% (interquartile range, IQR 18\u201337%). The ratio decreased to 10% (6\u201321%) after 6\u202fh and remained between 9\u201316% for up to 24\u202fh (with a low number of circuits used beyond 12\u202fh). Extraction ratios were similar in circuits with high (&amp;gt;1,000\u202fng\/L) and low baseline IL-6 levels. On the contrary, in circuits with high blood flow (\u2265200\u202fmL\/min, i.e., intermittent hemodialysis), the extraction ratio was very low (median 6%) at 6\u202fh and negligible thereafter, whereas the circuits with lower blood flow (&amp;lt;200\u202fmL\/min) maintained an extraction ratio of 20% for up to 12\u202fh.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We observed a significant reduction in the IL-6 extraction ratio within 6\u202fh in circuits with high blood flow, whereas circuits with lower blood flow maintained an adequate extraction ratio for up to 12\u202fh. Recent consensus recommendations on an 8\u201312\u202fh exchange interval should mainly be applied to continuous dialysis methods, whereas in intermittent hemodialysis, the exchanges should be more frequent.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1670620","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T05:28:57Z","timestamp":1760074137000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Interleukin-6 extraction ratios during prolonged CytoSorb hemoadsorption depend on procedural blood flow"],"prefix":"10.3389","volume":"12","author":[{"given":"Jakob","family":"Gubensek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Vajdic Trampuz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matej","family":"Zrimsek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanja","family":"Persic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1945","DOI":"10.1093\/ndt\/gfae089","article-title":"Hemoadsorption: consensus report of the 30th acute disease quality initiative workgroup","volume":"39","author":"Bellomo","year":"2024","journal-title":"Nephrol Dial Transplant"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1186\/s13054-023-04391-z","article-title":"CytoSorb hemoperfusion markedly attenuates circulating cytokine concentrations during systemic inflammation in humans in vivo","volume":"27","author":"Jansen","year":"2023","journal-title":"Crit Care"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1186\/s13054-023-04492-9","article-title":"Efficacy of CytoSorb: a systematic review and meta-analysis","volume":"27","author":"Becker","year":"2023","journal-title":"Crit Care"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1659","DOI":"10.1097\/CCM.0000000000006007","article-title":"The effect of CytoSorb on inflammatory markers in critically ill patients: a systematic review and meta-analysis of randomized controlled trials","volume":"51","author":"Heymann","year":"2023","journal-title":"Crit Care Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1097\/01.CCM.0000291646.34815.BB","article-title":"Feasibility study of cytokine removal by hemoadsorption in brain-dead humans","volume":"36","author":"Kellum","year":"2008","journal-title":"Crit Care Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e0187015","DOI":"10.1371\/journal.pone.0187015","article-title":"The effect of a novel extracorporeal cytokine hemoadsorption device on IL-6 elimination in septic patients: a randomized controlled trial","volume":"12","author":"Schaedler","year":"2017","journal-title":"PLoS One"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1186\/s13054-024-04968-2","article-title":"The phenomenon of desorption: what are the best adsorber exchange intervals?","volume":"28","author":"Buhlmann","year":"2024","journal-title":"Crit Care"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"7199","DOI":"10.3390\/jcm12237199","article-title":"Adjunctive hemoadsorption therapy with CytoSorb in patients with septic\/vasoplegic shock: a best practice consensus statement","volume":"12","author":"Mitzner","year":"2023","journal-title":"J Clin Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1186\/s12882-024-03679-8","article-title":"Hemoadsorption therapy for myoglobin removal in rhabdomyolysis: consensus of the hemoadsorption in rhabdomyolysis task force","volume":"25","author":"Forni","year":"2024","journal-title":"BMC Nephrol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1186\/s13054-024-04995-z","article-title":"Desorption in hemoadsorption therapies: a call for more data","volume":"28","author":"Jansen","year":"2024","journal-title":"Crit Care"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1159\/000534479","article-title":"Rapid and effective elimination of myoglobin with CytoSorb hemoadsorber in patients with severe rhabdomyolysis","volume":"53","author":"Albrecht","year":"2024","journal-title":"Blood Purif"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1177\/03913988231163608","article-title":"The application of hemoadsorption for hyperbilirubinemia and its impact on bilirubin removal kinetics in critically ill children","volume":"46","author":"Hui","year":"2023","journal-title":"Int J Artif Organs"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1186\/s13613-023-01198-7","article-title":"Extracorporeal adsorption of protective and toxic bile acids and bilirubin in patients with cholestatic liver dysfunction: a prospective study","volume":"13","author":"Greimel","year":"2023","journal-title":"Ann Intensive Care"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"21762","DOI":"10.1038\/s41598-024-72676-6","article-title":"Correlation of bilirubin and toxic bile acids in critically ill patients with cholestatic liver dysfunction and adsorber application","volume":"14","author":"Grafe","year":"2024","journal-title":"Sci Rep"},{"key":"ref15","article-title":"Extracorporeal bilirubin removal in a patient with bile cast nephropathy due to extreme hyperbilirubinemia\u2014a case report","volume-title":"7th Slovenian Congress of Nephrology, Book of abstracts","author":"Zrimsek","year":"2021"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1670620\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T05:28:58Z","timestamp":1760074138000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1670620\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,10]]},"references-count":15,"alternative-id":["10.3389\/fmed.2025.1670620"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1670620","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,10]]},"article-number":"1670620"}}