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Anti-inflammatory cytokines can cause relative immunosuppression leading to secondary nosocomial infections. Pro-inflammatory cytokines lead to vasodilation, capillary leakage, and coagulopathy. Massive release of cytokines into the bloodstream is the pathophysiological culprit of many life-threating diseases. To date, there is no evidence for a positive effect of the CytoSorb® adsorber on mortality across a variety of diagnoses that justifies its widespread use in intensive care medicine. All observational studies showed moderate to serious risk of bias. Of the eligible 34 studies only 12 were randomized controlled trials. We did not find significant differences in ICU length of stay, lactate levels, or IL-6 levels after treatment. In patients with cardiac arrest, we found a significant survival advantage of the untreated controls (1.22 ). Cytosorb® intervention did not lower mortality (RR : all studies 1.07, sepsis 0.98, CPB surgery 0.91, severe illness 0.95, SARS-CoV-2 1.58 ). Of an initial 1295 publications, 34 studies were found eligible, including 1297 patients treated with CytoSorb® and 1314 controls. The meta-analysis was registered in advance (PROSPERO: CRD42022290334). We analysed all studies combined and divided them into the subgroups: sepsis, cardiopulmonary bypass surgery (CPB), other severe illness, SARS-CoV-2 infection and recovery from cardiac arrest. We computed risk ratios and 95%-confidence intervals and used DerSimonian and Lairds random effects model. The longest reported mortality was defined as the primary endpoint. We considered randomized controlled trials and observational studies with control groups. We searched PubMed, Cochrane Library database and the database provided by Cytosorbents™ (–). The aim of this analysis is to provide evidence for the efficacy of the CytoSorb® adsorber with regard to mortality in various settings. Hackers can use this backdoor to take control of your computer, copy data from your computer or to use your computer to distribute viruses and spam to other people.Cytokine adsorption using the CytoSorb® adsorber has been proposed in various clinical settings including sepsis, ARDS, hyperinflammatory syndromes, cardiac surgery or recovery after cardiac arrest.
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