{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T21:36:41Z","timestamp":1793828201872,"version":"4.6.1"},"reference-count":64,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T00:00:00Z","timestamp":1732233600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Hungarian National Research, Development and Innovation Office","award":["K 138816"],"award-info":[{"award-number":["K 138816"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>A dysregulated immune response is associated with an excessive release of cytokines that can lead to systemic vasoplegia and vasoplegic shock with the development of multiorgan failure that is associated with an increased risk of dying. Under physiological circumstances, the endothelium and the glycocalyx are responsible for maintaining vascular tone, capillary permeability, and hemostasis, and controlling inflammation. In hyperinflammation, the endothelium and glycocalyx become damaged due to the excessive production of certain toxic proteins, along with an overwhelming release of cytokines. It has been shown in both in vitro animal experiments and in humans that extracorporeal hemoadsorption can reduce circulating levels of cytokines and may also remove toxic proteins that directly take part in endothelium and glycocalyx damage. The current review aims to summarize current knowledge, put recent findings into context, and introduce the hypothesis of \u201cendothelial protection with hemoadsorption\u201d in critically ill patients.<\/jats:p>","DOI":"10.3390\/jcm13237044","type":"journal-article","created":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T06:41:48Z","timestamp":1732257708000},"page":"7044","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Endothelial Protection and Improved Micro- and Macrocirculation with Hemoadsorption in Critically Ill Patients"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0765-794X","authenticated-orcid":false,"given":"Marton","family":"Papp","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Therapy, Semmelweis University, 78 \u00dcll\u0151i St., 1082 Budapest, Hungary"},{"name":"Centre for Translational Medicine, Semmelweis University, 22 Baross St., 1085 Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can","family":"Ince","sequence":"additional","affiliation":[{"name":"Laboratory for Translational Intensive Care, Department of Intensive Care, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2236-7391","authenticated-orcid":false,"given":"Jan","family":"Bakker","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care, New York University School of Medicine, New York, NY 10016, USA"},{"name":"Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians & Surgeons, New York, NY 10032, USA"},{"name":"Department of Intensive Care Adults, Erasmus MC University Medical Center, 3000 GD Rotterdam, The Netherlands"},{"name":"Department of Intensive Care, Pontificia Universidad Cat\u00f3lica de Chile, Santiago 8320165, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1468-4058","authenticated-orcid":false,"given":"Zsolt","family":"Molnar","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Therapy, Semmelweis University, 78 \u00dcll\u0151i St., 1082 Budapest, Hungary"},{"name":"Centre for Translational Medicine, Semmelweis University, 22 Baross St., 1085 Budapest, Hungary"},{"name":"Department of Anesthesiology and Intensive Therapy and Pain Medicine, Poznan University for Medical Sciences, 49 Przybyszewskiego St, 60-355 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/S0140-6736(19)32989-7","article-title":"Global, regional, and national sepsis incidence and mortality, 1990\u20132017: Analysis for the Global Burden of Disease Study","volume":"395","author":"Rudd","year":"2020","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1159\/000529569","article-title":"History and Development of Sorbents and Requirements for Sorbent Materials","volume":"200","author":"Ronco","year":"2023","journal-title":"Contrib. Nephrol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/S2213-2600(21)00451-3","article-title":"Extracorporeal haemoadsorption: Does the evidence support its routine use in critical care?","volume":"10","author":"Supady","year":"2022","journal-title":"Lancet Respir. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1097\/SHK.0000000000002121","article-title":"Hemoperfusion Using the Lps-Selective Mesoporous Polymeric Adsorbent in Septic Shock: A Multicenter Randomized Clinical Trial","volume":"59","author":"Rey","year":"2023","journal-title":"Shock"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1001\/archinte.167.15.1655","article-title":"Understanding the Inflammatory Cytokine Response in Pneumonia and Sepsis: Results of the Genetic and Inflammatory Markers of Sepsis (GenIMS) Study","volume":"167","author":"Kellum","year":"2007","journal-title":"Arch. Intern. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1097\/CCM.0b013e318170b9a7","article-title":"Effects of hemoadsorption on cytokine removal and short-term survival in septic rats","volume":"36","author":"Peng","year":"2008","journal-title":"Crit. Care Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1159\/000080235","article-title":"Cytokine removal with a novel adsorbent polymer","volume":"22","author":"Song","year":"2004","journal-title":"Blood Purif."},{"key":"ref_9","doi-asserted-by":"crossref","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":"ref_10","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1159\/000505899","article-title":"Successful Reduction of Creatine Kinase and Myoglobin Levels in Severe Rhabdomyolysis Using Extracorporeal Blood Purification (CytoSorb\u00ae)","volume":"49","author":"Dilken","year":"2020","journal-title":"Blood Purif."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1159\/000502540","article-title":"Changes in Cytokines, Haemodynamics and Microcirculation in Patients with Sepsis\/Septic Shock Undergoing Continuous Renal Replacement Therapy and Blood Purification with CytoSorb","volume":"49","author":"Zuccari","year":"2020","journal-title":"Blood Purif."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Bottari, G., Guzzo, I., Cappoli, A., Labbadia, R., Perdichizzi, S., Serpe, C., Creteur, J., Cecchetti, C., and Taccone, F.S. (2023). Impact of CytoSorb and CKRT on hemodynamics in pediatric patients with septic shock: The PedCyto study. Front. Pediatr., 11.","DOI":"10.3389\/fped.2023.1259384"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1177\/0391398820902469","article-title":"Hemoperfusion with Cytosorb in pediatric patients with septic shock: A retrospective observational study","volume":"43","author":"Bottari","year":"2020","journal-title":"Int. J. Artif. Organs"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1007\/s10047-017-0967-4","article-title":"Extracorporeal cytokine elimination as rescue therapy in refractory septic shock: A prospective single-center study","volume":"20","author":"Friesecke","year":"2017","journal-title":"J. Artif. Organs"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Hawchar, F., Tomescu, D., Tr\u00e4ger, K., Joskowiak, D., Kogelmann, K., Soukup, J., Friesecke, S., Jacob, D., Gummert, J., and Faltlhauser, A. (2022). Hemoadsorption in the critically ill\u2014Final results of the International CytoSorb Registry. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0274315"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.jcrc.2018.11.003","article-title":"Extracorporeal cytokine adsorption in septic shock: A proof of concept randomized, controlled pilot study","volume":"49","author":"Hawchar","year":"2019","journal-title":"J. Crit. Care"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Kogelmann, K., H\u00fcbner, T., Schwameis, F., Dr\u00fcner, M., Scheller, M., and Jarczak, D. (2021). First Evaluation of a New Dynamic Scoring System Intended to Support Prescription of Adjuvant CytoSorb Hemoadsorption Therapy in Patients with Septic Shock. J. Clin. Med., 10.","DOI":"10.3390\/jcm10132939"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1186\/s13054-017-1662-9","article-title":"Hemoadsorption by CytoSorb in septic patients: A case series","volume":"21","author":"Kogelmann","year":"2017","journal-title":"Crit. Care"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Rugg, C., Klose, R., Hornung, R., Innerhofer, N., Bachler, M., Schmid, S., Fries, D., and Str\u00f6hle, M. (2020). Hemoadsorption with CytoSorb in Septic Shock Reduces Catecholamine Requirements and In-Hospital Mortality: A Single-Center Retrospective \u2018Genetic\u2019 Matched Analysis. Biomedicines, 8.","DOI":"10.3390\/biomedicines8120539"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1159\/000512309","article-title":"Improved Survival beyond 28 Days up to 1 Year after CytoSorb Treatment for Refractory Septic Shock: A Propensity-Weighted Retrospective Survival Analysis","volume":"50","author":"Brouwer","year":"2021","journal-title":"Blood Purif."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1186\/s13054-019-2588-1","article-title":"Hemoadsorption with CytoSorb shows a decreased observed versus expected 28-day all-cause mortality in ICU patients with septic shock: A propensity-score-weighted retrospective study","volume":"23","author":"Brouwer","year":"2019","journal-title":"Crit. Care"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1007\/s00134-021-06506-y","article-title":"Surviving sepsis campaign: International guidelines for management of sepsis and septic shock 2021","volume":"47","author":"Evans","year":"2021","journal-title":"Intensiv. Care Med."},{"key":"ref_23","doi-asserted-by":"crossref","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":"ref_24","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1186\/s13054-023-04492-9","article-title":"Efficacy of CytoSorb(R): A systematic review and meta-analysis","volume":"27","author":"Becker","year":"2023","journal-title":"Crit. Care"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e0688","DOI":"10.1097\/CCE.0000000000000688","article-title":"Mechanistic Considerations and Pharmacokinetic Implications on Concomitant Drug Administration During CytoSorb Therapy","volume":"4","author":"Scheier","year":"2022","journal-title":"Crit. Care Explor."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1186\/s13054-019-2399-4","article-title":"Cytokine clearance with CytoSorb\u00ae during cardiac surgery: A pilot randomized controlled trial","volume":"23","author":"Poli","year":"2019","journal-title":"Crit. Care"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1080\/14728222.2021.1988928","article-title":"Endothelial dysfunction: A therapeutic target in bacterial sepsis?","volume":"25","author":"Vincent","year":"2021","journal-title":"Expert Opin. Ther. Targets"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.cardiores.2006.11.021","article-title":"The endothelial glycocalyx affords compatibility of Starling\u2019s principle and high cardiac interstitial albumin levels","volume":"73","author":"Jacob","year":"2007","journal-title":"Cardiovasc. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1159\/000322176","article-title":"Endothelial glycocalyx structure in the intact carotid artery: A two-photon laser scanning microscopy study","volume":"48","author":"Reitsma","year":"2011","journal-title":"J. Vasc. Res."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Villalba, N., Baby, S., and Yuan, S.Y. (2021). The Endothelial Glycocalyx as a Double-Edged Sword in Microvascular Homeostasis and Pathogenesis. Front. Cell Dev. Biol., 9.","DOI":"10.3389\/fcell.2021.711003"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1164\/rccm.201910-1911TR","article-title":"Endothelial Responses in Sepsis","volume":"202","author":"Joffre","year":"2020","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"655","DOI":"10.5114\/aoms.2017.69771","article-title":"Ringer\u2019s lactate solution enhances the inflammatory response during fluid resuscitation of experimentally induced haemorrhagic shock in rats","volume":"14","author":"Kusza","year":"2018","journal-title":"Arch. Med. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"S8","DOI":"10.1186\/cc14726","article-title":"Hemodynamic coherence and the rationale for monitoring the microcirculation","volume":"19","author":"Ince","year":"2015","journal-title":"Crit. Care"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1093\/ndt\/gfad142","article-title":"Sepsis-associated acute kidney injury\u2014Treatment standard","volume":"39","author":"Zarbock","year":"2023","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Saemann, L., Hoorn, F., Georgevici, A.-I., Pohl, S., Korkmaz-Ic\u00f6z, S., Veres, G., Guo, Y., Karck, M., Simm, A., and Wenzel, F. (2022). Cytokine Adsorber Use during DCD Heart Perfusion Counteracts Coronary Microvascular Dysfunction. Antioxidants, 11.","DOI":"10.3390\/antiox11112280"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Denzinger, M., Staendker, L., Ehlers, K., Schneider, J.M., Schulz, T., Hein, T., Wiese, S., Roecker, A., Gross, R., and M\u00fcnch, J. (2019). Bioassay for Endothelial Damage Mediators Retrieved by Hemoadsorption. Sci. Rep., 9.","DOI":"10.1038\/s41598-019-50517-1"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Piskovatska, V., Santos, A.N., Kalies, K., Korca, E., Stiller, M., Szab\u00f3, G., Simm, A., and W\u00e4chter, K. (2023). Proteins Adsorbed during Intraoperative Hemoadsorption and Their In Vitro Effects on Endothelium. Healthcare, 11.","DOI":"10.3390\/healthcare11030310"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s40560-017-0208-1","article-title":"Effect of extracorporeal cytokine removal on vascular barrier function in a septic shock patient","volume":"5","author":"David","year":"2017","journal-title":"J. Intensiv. Care"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1007\/s10456-024-09916-w","article-title":"Interleukin-6 drives endothelial glycocalyx damage in COVID-19 and bacterial sepsis","volume":"27","author":"Drost","year":"2024","journal-title":"Angiogenesis"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1097\/00003246-199806000-00015","article-title":"Mortality is increased by procalcitonin and decreased by an antiserum reactive to procalcitonin in experimental sepsis","volume":"26","author":"Nylen","year":"1998","journal-title":"Crit. Care Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1164\/rccm.202201-0054OC","article-title":"Targeting Procalcitonin Protects Vascular Barrier Integrity","volume":"206","author":"Brabenec","year":"2022","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1053\/j.jvca.2020.06.028","article-title":"Modulating the Inflammatory Response With Hemadsorption (CytoSorb) in Patients Undergoing Major Aortic Surgery","volume":"35","author":"Mehta","year":"2021","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1055\/s-0040-1708479","article-title":"Combined Use of CytoSorb and ECMO in Patients with Severe Pneumogenic Sepsis","volume":"69","author":"Akil","year":"2021","journal-title":"Thorac. Cardiovasc. Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"214","DOI":"10.4103\/0971-9784.179588","article-title":"Soluble urokinase plasminogen activation receptor\u2014An emerging new biomarker of cardiovascular disease and critical illness","volume":"19","author":"Ramakrishna","year":"2016","journal-title":"Ann. Card. Anaesth."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Vicka, V., Januskeviciute, E., Bartu\u0161eviciene, I., Ringaitiene, D., Aleknaviciene, A., Serpytis, M., Rimsevicius, L., Miglinas, M., Jancoriene, L., and Sipylaite, J. (2022). Kinetics of SuPAR hemoadsorption in critical COVID-19 patients on renal replacement therapy. BMC Nephrol., 23.","DOI":"10.1186\/s12882-022-03003-2"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1093\/ckj\/sfz173","article-title":"Relationship between soluble urokinase-type plasminogen activator receptor and serum biomarkers of endothelial activation in patients with idiopathic nephrotic syndrome","volume":"14","author":"Roca","year":"2021","journal-title":"Clin. Kidney J."},{"key":"ref_47","first-page":"e165740","article-title":"suPAR links a dysregulated immune response to tissue inflammation and sepsis-induced acute kidney injury","volume":"8","author":"Nusshag","year":"2023","journal-title":"J. Clin. Investig."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1002\/jca.21538","article-title":"Removal of focal segmental glomerulosclerosis (FSGS) factor suPAR using CytoSorb","volume":"32","author":"Schenk","year":"2017","journal-title":"J. Clin. Apher."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e20211463","DOI":"10.1084\/jem.20211463","article-title":"Inhibitory pattern recognition receptors","volume":"219","author":"Rumpret","year":"2022","journal-title":"J. Exp. Med."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Li, L., and Lu, Y.-Q. (2020). The Regulatory Role of High-Mobility Group Protein 1 in Sepsis-Related Immunity. Front. Immunol., 11.","DOI":"10.3389\/fimmu.2020.601815"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"5928078","DOI":"10.1155\/2017\/5928078","article-title":"HMGB1 and Extracellular Histones Significantly Contribute to Systemic Inflammation and Multiple Organ Failure in Acute Liver Failure","volume":"2017","author":"Yang","year":"2017","journal-title":"Mediat. Inflamm."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.3748\/wjg.v21.i5.1424","article-title":"High-mobility group box 1 protein and its role in severe acute pancreatitis","volume":"21","author":"Shen","year":"2015","journal-title":"World J. Gastroenterol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1164\/rccm.201206-1037OC","article-title":"Circulating Histones Are Mediators of Trauma-associated Lung Injury","volume":"187","author":"Abrams","year":"2013","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2493","DOI":"10.3324\/haematol.2021.278492","article-title":"Circulating histones play a central role in COVID-19-associated coagulopathy and mortality","volume":"106","author":"Shaw","year":"2021","journal-title":"Haematologica"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Gruda, M.C., Ruggeberg, K.-G., O\u2019sullivan, P., Guliashvili, T., Scheirer, A.R., Golobish, T.D., Capponi, V.J., and Chan, P.P. (2018). Broad adsorption of sepsis-related PAMP and DAMP molecules, mycotoxins, and cytokines from whole blood using CytoSorb\u00ae sorbent porous polymer beads. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0191676"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Weber, B., Lackner, I., Baur, M., Fois, G., Gebhard, F., Marzi, I., Schrezenmeier, H., Relja, B., and Kalbitz, M. (2020). Effects of Circulating HMGB-1 and Histones on Cardiomyocytes\u2013Hemadsorption of These DAMPs as Therapeutic Strategy after Multiple Trauma. J. Clin. Med., 9.","DOI":"10.3390\/jcm9051421"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"361","DOI":"10.5603\/AIT.2014.0060","article-title":"Fluid overload, de-resuscitation, and outcomes in critically ill or injured patients: A systematic review with suggestions for clinical practice","volume":"46","author":"Malbrain","year":"2014","journal-title":"Anaesthesiol. Intensiv. Ther."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1007\/s00134-019-05801-z","article-title":"Vasopressor therapy in critically ill patients with shock","volume":"45","author":"Russell","year":"2019","journal-title":"Intensiv. Care Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1159\/000518903","article-title":"Sublingual Microcirculatory Evaluation of Extracorporeal Hemoadsorption with CytoSorb\u00ae in Abdominal Sepsis: A Case Report","volume":"51","author":"Duran","year":"2022","journal-title":"Blood Purif."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1186\/s13054-023-04474-x","article-title":"The future of intensive care: The study of the microcirculation will help to guide our therapies","volume":"27","author":"Duranteau","year":"2023","journal-title":"Crit. Care"},{"key":"ref_61","first-page":"9852073","article-title":"Cytokine Reduction in the Setting of an ARDS-Associated Inflammatory Response with Multiple Organ Failure","volume":"2016","author":"Fischer","year":"2016","journal-title":"Case Rep. Crit. Care"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1186\/s13054-023-04517-3","article-title":"Extracorporeal hemoadsorption in critically ill COVID-19 patients on VV ECMO: The CytoSorb therapy in COVID-19 (CTC) registry","volume":"27","author":"Hayanga","year":"2023","journal-title":"Crit. Care"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Kogelmann, K., H\u00fcbner, T., Dr\u00fcner, M., and Jarczak, D. (2024). Impact of CytoSorb Hemoadsorption Therapy on Fluid Balance in Patients with Septic Shock. J. Clin. Med., 13.","DOI":"10.3390\/jcm13010294"},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Szigetv\u00e1ry, C.E., Turan, C., Kov\u00e1cs, E.H., K\u00f3i, T., Engh, M.A., Hegyi, P., Csukly, G., Ruszkai, Z., and Moln\u00e1r, Z. (2023). Hemoadsorption as Adjuvant Therapy in Acute Respiratory Distress Syndrome (ARDS): A Systematic Review and Meta-Analysis. Biomedicines, 11.","DOI":"10.3390\/biomedicines11113068"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/23\/7044\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:37:14Z","timestamp":1760114234000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/23\/7044"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,22]]},"references-count":64,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["jcm13237044"],"URL":"https:\/\/doi.org\/10.3390\/jcm13237044","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,22]]}}}