# A Contemporary Review of the Use of Extracorporeal CytoSorb® Hemoadsorption Therapy in Patients with Infective Endocarditis

## TL;DR

This paper reviews the use of CytoSorb® hemoadsorption therapy in patients with infective endocarditis undergoing heart surgery.

## Contribution

The paper provides a contemporary review of CytoSorb® hemoadsorption therapy's role in managing inflammatory responses in infective endocarditis.

## Key findings

- Extracorporeal hemoadsorption with CytoSorb® is proposed to reduce inflammatory responses during cardiac surgery.
- There is a lack of systematic evaluation of CytoSorb®'s impact on outcomes like organ dysfunction and mortality in IE patients.

## Abstract

Infective endocarditis (IE) is a rare but severe disease with high morbidity and mortality. Cardiac surgery plays a major role in the contemporary clinical management of IE patients. During cardiac surgery, cardiopulmonary bypass significantly contributes to an increased risk of organ dysfunction and mortality by inducing an acute inflammatory response, vascular endothelial cell injury, impairment of the coagulation cascade, and ischemia–reperfusion injury. During the past decade, the use of extracorporeal hemoadsorption therapy with the CytoSorb® hemoadsorber (CytoSorbents Europe GmbH, Berlin, Germany) has been proposed as an adjuvant therapy to mediate inflammatory responses in IE patients undergoing cardiac surgery with cardiopulmonary bypass. However, there is currently no systematic evaluation of the effect of CytoSorb® hemoadsorption on clinical outcomes such as hemodynamics, organ dysfunction, and mortality in patients with IE. Therefore, in this review, we exclusively discuss contemporary findings concerning the rationale, clinical evidence, and future perspectives for CytoSorb® hemoadsorption therapy in IE patients.