Extracorporeal cytokine adsorption therapy (ECAT) aims to reduce the cytokine concentration in the blood, thereby stabilising the overall immune response in sepsis and SIRS (Systemic Inflammatory Response Syndrome). We investigated the efficacy and safety of ECAT in its two main indications: to treat sepsis and to prevent SIRS (Systemic Inflammatory Response Syndrome) during cardiopulmonary bypass surgery.

This update systematic review captures evidence consisting of seven randomised controlled trials: Five randomised controlled trials with a total of 197 enrolled patients (of whom 163 were analysed) investigated the preventive use of the technology in patients undergoing cardiac surgery. Further two randomised controlled trials with 120 enrolled patients (of whom 117 were analysed) investigated the therapeutic use of the technology in patients with sepsis or septic shock. Overall, the certainty of the evidence was very low mainly due to high imprecision and the high risk of bias in most of the included studies.

Current evidence is insufficient to show a clinical benefit of ECAT used as an add-on measure preventively in cardiac surgery or therapeutically in patients with sepsis or septic shock. Based on the selected patient-relevant crucial outcomes, none of the studies was able to demonstrate that ECAT and standard care is more effective than -and as safe- as standard care alone in these two assessed conditions.