CytoSorb® in burn patients with septic shock and Acute Kidney Injury on Continuous Kidney Replacement Therapy is associated with improved clinical outcome and survival

In burn patients, septic shock and AKI requiring Continuous Kidney Replacement Therapy (CKRT) severely increase morbidity and mortality. Sorbent therapies could be an adjunctive therapy to address the underlying metabolic changes in inflammatory and anti-inflammatory cytokines dysregulated production. A retrospectively observational study of 35 severe burn patients admitted to the Burn Center (Turin, Italy, from January 2017 to December 2022), who underwent CKRT for AKI-associated septic shock. Out of 35 patients, 11 were treated with CytoSorb® as adjunctive therapy to CKRT (Sorbent group) and 24 patients only with CKRT (Control group). The application of CytoSorb® took place in a very dispersed way. Out of 11 patients, 7 started the CKRT together with the sorbent application. The patients of the Sorbent group exhibited a significant reduction in norepinephrine requirement compared to that of the Control group. A clinical improvement over the first 4 days of Cytosorb® was observed in both survivors and no survivors of the Sorbent group, with significant norepinephrine decreased requirement on day 4 compared to day 1. In-hospital mortality was 45.4% and 70.8% in the Sorbent and Control group, respectively, and significantly better at K-M survival analysis at 270 days (p = 0.0445). In both groups, all survivor patients recovered renal function at discharge, whereas no survivors did not. Adjunctive treatment with CytoSorb® for burn patients with AKI-CKRT and septic shock poorly responsive to standard therapy led to a significant clinical improvement, and was associated with a lower mortality rate compared to CKRT alone.