Use of CytoSorb in Traumatic Amputation of the Forearm and Severe Septic Shock

Severe trauma associated with later disability and mortality still constitutes a major health and socioeconomic problem throughout the world. While primary morbidity and mortality are mostly related to initial injuries and early complications, secondary lethality is strongly linked to the developmen...

Full description

Saved in:
Bibliographic Details
Main Authors: Heinz Steltzer, Alexander Grieb, Karim Mostafa, Reinhard Berger
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Critical Care
Online Access:http://dx.doi.org/10.1155/2017/8747616
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850222750938955776
author Heinz Steltzer
Alexander Grieb
Karim Mostafa
Reinhard Berger
author_facet Heinz Steltzer
Alexander Grieb
Karim Mostafa
Reinhard Berger
author_sort Heinz Steltzer
collection DOAJ
description Severe trauma associated with later disability and mortality still constitutes a major health and socioeconomic problem throughout the world. While primary morbidity and mortality are mostly related to initial injuries and early complications, secondary lethality is strongly linked to the development of systemic inflammatory response syndrome, sepsis, and ultimately multiple organ dysfunction syndrome. We herein report on a 49-year-old male patient who was admitted to the hospital after a traumatic amputation of his right forearm that was cut off while working on a landfill. After initial treatment for shock, he received immediate replantation and was transferred to the ICU. Due to the anticipated risk of a complex infection, continuous renal replacement therapy in combination with CytoSorb was initiated. During the course of the combined treatment, a rapid improvement in hemodynamics was noticed, as well as a significant reduction of IL-6 and lactate levels. Despite a recurring septic episode and the necessity for amputation, the patient clinically stabilized and underwent complete recovery. The early treatment with a combination of CVVHDF and CytoSorb was accompanied by an attenuation of the systemic inflammatory reaction, which subsided without major or permanent organ damage, despite the impressive pathogen spectrum and the pronounced local damage.
format Article
id doaj-art-6fac02098a5441a5a4a30e956dce6fa5
institution OA Journals
issn 2090-6420
2090-6439
language English
publishDate 2017-01-01
publisher Wiley
record_format Article
series Case Reports in Critical Care
spelling doaj-art-6fac02098a5441a5a4a30e956dce6fa52025-08-20T02:06:13ZengWileyCase Reports in Critical Care2090-64202090-64392017-01-01201710.1155/2017/87476168747616Use of CytoSorb in Traumatic Amputation of the Forearm and Severe Septic ShockHeinz Steltzer0Alexander Grieb1Karim Mostafa2Reinhard Berger3AUVA-Unfallkrankenhaus Meidling, Department of Anesthesiology and Intensive Care Medicine, Vienna, AustriaAUVA-Unfallkrankenhaus Meidling, Department of Anesthesiology and Intensive Care Medicine, Vienna, AustriaAUVA-Unfallkrankenhaus Meidling, Department of Anesthesiology and Intensive Care Medicine, Vienna, AustriaAUVA-Unfallkrankenhaus Meidling, Department of Anesthesiology and Intensive Care Medicine, Vienna, AustriaSevere trauma associated with later disability and mortality still constitutes a major health and socioeconomic problem throughout the world. While primary morbidity and mortality are mostly related to initial injuries and early complications, secondary lethality is strongly linked to the development of systemic inflammatory response syndrome, sepsis, and ultimately multiple organ dysfunction syndrome. We herein report on a 49-year-old male patient who was admitted to the hospital after a traumatic amputation of his right forearm that was cut off while working on a landfill. After initial treatment for shock, he received immediate replantation and was transferred to the ICU. Due to the anticipated risk of a complex infection, continuous renal replacement therapy in combination with CytoSorb was initiated. During the course of the combined treatment, a rapid improvement in hemodynamics was noticed, as well as a significant reduction of IL-6 and lactate levels. Despite a recurring septic episode and the necessity for amputation, the patient clinically stabilized and underwent complete recovery. The early treatment with a combination of CVVHDF and CytoSorb was accompanied by an attenuation of the systemic inflammatory reaction, which subsided without major or permanent organ damage, despite the impressive pathogen spectrum and the pronounced local damage.http://dx.doi.org/10.1155/2017/8747616
spellingShingle Heinz Steltzer
Alexander Grieb
Karim Mostafa
Reinhard Berger
Use of CytoSorb in Traumatic Amputation of the Forearm and Severe Septic Shock
Case Reports in Critical Care
title Use of CytoSorb in Traumatic Amputation of the Forearm and Severe Septic Shock
title_full Use of CytoSorb in Traumatic Amputation of the Forearm and Severe Septic Shock
title_fullStr Use of CytoSorb in Traumatic Amputation of the Forearm and Severe Septic Shock
title_full_unstemmed Use of CytoSorb in Traumatic Amputation of the Forearm and Severe Septic Shock
title_short Use of CytoSorb in Traumatic Amputation of the Forearm and Severe Septic Shock
title_sort use of cytosorb in traumatic amputation of the forearm and severe septic shock
url http://dx.doi.org/10.1155/2017/8747616
work_keys_str_mv AT heinzsteltzer useofcytosorbintraumaticamputationoftheforearmandseveresepticshock
AT alexandergrieb useofcytosorbintraumaticamputationoftheforearmandseveresepticshock
AT karimmostafa useofcytosorbintraumaticamputationoftheforearmandseveresepticshock
AT reinhardberger useofcytosorbintraumaticamputationoftheforearmandseveresepticshock