SIRS Clinical Trial
Official title:
Pancreatitis CytoSorbents (CytoSorb®) Inflammatory Cytokine Removal: A Prospective Study.
Severe acute pancreatitis (SAP) has a mortality of up to 42%. The outcome of SAP is related
to the development of SIRS and consecutive organ failures. Due to the lack of a causative
therapy except the removal of bile duct stones, therapy is predominantly symptomatic.
With regard to a marked inflammatory response ("cytokine storm") during the early phase of
SAP extracorporeal cytokine removal is a promising therapeutic approach.
This prospective case control study investigates the impact of early extracorporeal cytokine
adsorption with the CytoSorb®-device on haemodynamics (primary endpoint) and several
secondary outcomes.
Severe acute pancreatitis (SAP) has a mortality of up to 42%. The outcome of SAP is related
to the development of SIRS and consecutive organ failures. Due to the lack of a causative
therapy except the removal of bile duct stones, therapy is predominantly symptomatic.
Severity and mortality are associated to an early systemic inflammatory response syndrome
(SIRS) and to septic complications at a later stage of disease.
With regard to a marked inflammatory response ("cytokine storm") during the early phase of
SAP extracorporeal cytokine removal is a promising therapeutic approach.
This prospective case control study investigates the impact of early extracorporeal cytokine
adsorption with the CytoSorb® device on haemodynamics (primary endpoint) and several
secondary outcomes.
Patients with high probability of SAP (APACHE-II-score ≥10) are eligible for 7 days after
the onset of pain.
The patients will be treated for 48h with two consecutive 24h sessions of cytokine
absorption with the CytoSorb®-device.
All patients will be under haemodynamic Monitoring with transpulmonary thermodilution The
primary endpoint is defined as an improvement of the vasopressor dependency index of ≥20%
(if no vasoactive drugs are used at baseline, the cardiac power index cardiac power index
(CPI) will be used as primary endpoint).
The outcome analysis will be based on comparison of the incidence of the primary endpoint in
30 Intervention patients compared to 60 matched controls.
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