{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:15:43Z","timestamp":1785417343426,"version":"3.56.0"},"reference-count":30,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T00:00:00Z","timestamp":1780790400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Education Planning Board of Cemil Ta\u015fc\u0131o\u011flu City Hospital"},{"id":[{"id":"https:\/\/ror.org\/031zc8d88","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Vasoplegic shock (VS) in critically ill patients without microbiological evidence of infection poses a major clinical challenge in intensive care units (ICUs). Extracorporeal cytokine hemadsorption using the oXiris\u00ae membrane\u2014a high-permeability polyacrylonitrile-based (AN69-ST) filter with adsorptive properties against inflammatory mediators\u2014has emerged as a potential adjunct to restore haemodynamic stability. Evidence supporting its use remains limited, particularly regarding timing of initiation and downstream mortality biomarkers. Methods: We conducted a single-centre prospective observational study at the ICU of Istanbul Prof. Dr. Cemil Ta\u015fc\u0131o\u011flu City Hospital between October 2022 and January 2023. Adults aged \u226518 years with VS (CRP \u2265 100 mg\/L, procalcitonin [PCT] &lt; 2 \u03bcg\/L, no positive microbiological culture) requiring continuous renal replacement therapy (CRRT) with the oXiris\u00ae membrane were enrolled (n = 34), of whom 30 completed the study period without microbiological exclusion and comprised the final analysis cohort. Pre- and post-treatment (72 h) clinical and cytokine parameters were compared. The association of VS resolution and 7-day mortality with timing of oXiris\u00ae initiation, cytokine levels, and treatment duration was assessed. This study was conducted and reported in accordance with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement. Results: Significant changes were observed across all principal haemodynamic and inflammatory parameters at 72 h of oXiris\u00ae treatment, including mean arterial pressure (MAP: 50.8 \u00b1 6.3 to 69.3 \u00b1 17 mmHg, p &lt; 0.001), SOFA score (8.33 \u00b1 2.29 to 4.9 \u00b1 3.22, p &lt; 0.001), IL-6 (767.3 \u00b1 1205.7 to 294.4 \u00b1 686.3 pg\/mL, p &lt; 0.001), IL-1\u03b2, TNF-\u03b1, CRP, lactate, and creatinine. VS resolved in 24\/30 patients (80%). Younger age was associated with VS resolution (57.8 \u00b1 19.7 vs. 76.6 \u00b1 13.9 years; p = 0.021). Initiation of oXiris\u00ae within 8 h was associated with significantly shorter VS resolution time (52.5 \u00b1 23.9 vs. 85.9 \u00b1 48.2 h; p = 0.045). Seven-day mortality was 20% (n = 6) and hospital mortality was 50% (n = 15). Post-treatment IL-1\u03b2 (856.7 \u00b1 548.5 vs. 1086.9 \u00b1 353.6 pg\/mL; p = 0.044) and TNF-\u03b1 (111.0 \u00b1 70.0 vs. 145.4 \u00b1 47.8 pg\/mL; p = 0.011) at 72 h were significantly higher in hospital non-survivors, representing exploratory prognostic associations. Conclusions: Changes in haemodynamic and inflammatory parameters were observed during oXiris\u00ae-based CRRT treatment in critically ill patients with non-septic VS. Early initiation (\u22648 h) was associated with shorter VS resolution time in this exploratory, uncontrolled analysis. Residual IL-1\u03b2 and TNF-\u03b1 at 72 h were associated with hospital mortality in exploratory analyses and may represent hypothesis-generating prognostic signals requiring prospective validation. Randomised controlled trials are warranted to confirm these findings and define optimal timing strategies.<\/jats:p>","DOI":"10.3390\/jcm15124414","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T05:43:46Z","timestamp":1780897426000},"page":"4414","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Extracorporeal Cytokine Hemadsorption with oXiris\u00ae in Critically Ill Patients with Non-Septic Vasoplegic Shock: Hemodynamic Effects, Cytokine Kinetics, and Mortality Outcomes"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4439-661X","authenticated-orcid":false,"given":"Hakan","family":"K\u00fc\u00e7\u00fckkepeci","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Reanimation, \u015e\u0131rnak Cizre Dr. Selahattin Cizrelio\u011flu State Hospital, \u015e\u0131rnak 73200, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinan","family":"Mutlu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, \u015e\u0131rnak Cizre Dr. Selahattin Cizrelio\u011flu State Hospital, \u015e\u0131rnak 73200, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasim Onur","family":"Karao\u011flu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, SB\u00dc Ba\u011fc\u0131lar Training and Research Hospital, Istanbul 34200, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A\u00e7elya","family":"Toprak Karao\u011flu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Zeynep Kamil Maternity and Children\u2019s Hospital, Istanbul 34668, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zge","family":"Say\u0131n","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Ege University Faculty of Medicine, Izmir 35100, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namigar","family":"Turgut","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Prof. Dr. Cemil Ta\u015fc\u0131o\u011flu City Hospital, Istanbul 34384, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1186\/s13054-018-2102-1","article-title":"Definitions and pathophysiology of vasoplegic shock","volume":"22","author":"Lambden","year":"2018","journal-title":"Crit. 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