# Does adjunctive hemoadsorption provide benefit in the management of ischemia–reperfusion syndrome following near-drowning? A case report

## TL;DR

This case report explores the use of hemoadsorption to manage inflammation after near-drowning, suggesting it could be a helpful addition to standard treatments.

## Contribution

The paper presents a novel application of CytoSorb® hemoadsorption in treating ischemia–reperfusion injury following near-drowning.

## Key findings

- CytoSorb® effectively removes pro-inflammatory mediators in a near-drowning case.
- Adjunctive hemoadsorption may help manage hyperinflammation from ischemia–reperfusion injury.
- The case suggests potential for improved outcomes with this added therapy.

## Abstract

Drowning remains a significant global health concern, claiming over 300,000 lives annually, with a disproportionate impact on young individuals in low-and middle-income countries. Conventional mechanical ventilation, while common, falls short in addressing the hypoxemia and hypercapnia often observed in severe near-drowning cases. Veno-venous extracorporeal membrane oxygenation (vvECMO) emerges as a critical intervention for cardiopulmonary failure post-drowning. This case report delves into the pivotal role of ischemia–reperfusion injury (IRI) in a near-drowning-related pathology. Following the initial insult, reoxygenation exacerbates the inflammatory cascade, resulting in a surge of pro-inflammatory mediators. In this context, CytoSorb®, a hemoadsorption cartridge, demonstrates promise by effectively removing these mediators from circulation. This report outlines its application in a critically ill adolescent patient who experienced near-drowning, presenting a compelling case for CytoSorb as an adjunctive therapy in managing IRI-induced hyperinflammation.