Potential correlation between hemodynamic improvement and an immune-modulation effect in pediatric patients with septic shock treated with renal replacement therapy and CytoSorb ® : an insight from the PedCyto study

Because of the underlying dysregulated response to infection, extracorporeal therapies may help with an overwhelming cytokine production associated with fulminant septic shock and early death, but also for reducing the risk of developing immune-paralysis, which is correlated to late mortality [1, 2]. [...]evidence that 24 h after the end of hemoadsorption, no rebound effect was observed, suggests that the extracorporeal therapeutic effect could induce a substantial impact on immune-homeostasis. The main limitation of our study is the lack of a control group confirming irrevocably that the substantial reduction in the cytokine levels observed was associated with the adjuvant therapy and not the consequence of the natural course of the illness or potential effects of the standard therapy.