{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T15:03:48Z","timestamp":1775142228341,"version":"3.50.1"},"reference-count":46,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: The impact of CytoSorb hemoadsorption on hemodynamic stability, mortality, and intensive care unit length of stay in critically ill adult patients requiring vasopressor support is unclear. Methods: Systematic review and meta-analysis of randomized controlled trials and observational studies, enrolling adult intensive care unit patients requiring vasopressor support. We compared CytoSorb hemoadsorption versus standard care or control interventions. Results: Twelve studies enrolling 568 patients met the inclusion criteria. Primary outcomes included noradrenaline dosage, mortality at longest follow-up, and intensive care unit length of stay. CytoSorb treatment significantly reduced noradrenaline requirements (mean difference \u22120.08 \u03bcg\/kg\/min [95% CI: \u22120.15 to \u22120.02], p = 0.02, I2 = 8%). Mortality at the longest follow-up was lower with CytoSorb (risk ratio 0.66 [95% CI: 0.55\u20130.80], p &lt; 0.001, I2 = 0%), though this finding was driven primarily by observational studies; randomized controlled trials alone showed non-significant mortality reduction (risk ratio 0.23 [95% CI: 0.05\u20131.06], p = 0.06). No difference in intensive care unit length of stay was observed (mean difference 0.24 days [95% CI: \u22121.23 to 1.70], p = 0.75). Trial sequential analysis indicated insufficient information size for definitive conclusions. Overall evidence quality was low to very low. Conclusions: CytoSorb hemoadsorption may reduce vasopressor requirements in critically ill patients. Observed mortality benefits were driven primarily by observational studies, with RCTs showing non-significant trends. Overall evidence quality is low, and findings should be considered hypothesis-generating; adequately powered RCTs are needed before clinical recommendations can be made.<\/jats:p>","DOI":"10.3390\/life16040576","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T14:09:54Z","timestamp":1775138994000},"page":"576","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effects of CytoSorb in Critically Ill Adult Patients on Vasopressor Support: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5136-8323","authenticated-orcid":false,"given":"Martina","family":"Giacco","sequence":"first","affiliation":[{"name":"School of Medicine and Surgery, University of Enna \u201cKORE\u201d, 94100 Enna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benedetta","family":"Savasta","sequence":"additional","affiliation":[{"name":"School of Medicine and Surgery, University of Enna \u201cKORE\u201d, 94100 Enna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3150-399X","authenticated-orcid":false,"given":"Andrea","family":"Montisci","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Intensive Care, ASST Spedali Civili, 25123 Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Pappalardo","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Enna \u201cKORE\u201d, 94100 Enna, Italy"},{"name":"Centro Cuore GB Morgagni, 95125 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2156-7554","authenticated-orcid":false,"given":"Luigi","family":"La Via","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Medical-Surgical Specialties, University of Catania, 95123 Catania, Italy"},{"name":"Department of Anesthesia and Intensive Care, University Hospital Policlinico \u201cG. Rodolico\u2013San Marco\u201d, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,1]]},"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":"16045","DOI":"10.1038\/nrdp.2016.45","article-title":"Sepsis and septic shock","volume":"2","author":"Hotchkiss","year":"2016","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1164\/rccm.201604-0862CP","article-title":"Potentially inadvertent immunomodulation: Norepinephrine use in sepsis","volume":"194","author":"Stolk","year":"2016","journal-title":"Am. J. Respir. Crit. 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