The device, called CytoSorb, is about the size of a drinking glass and is filled with coarse polymers, each roughly the size of a grain of salt. Each grain or pearl has millions of pores and channels that total about seven football fields and filter out molecules about the size of cytokines. A cartridge can purify the entire body’s blood volume about 70 times in 24 hours.
Larger objects, like cells, surround the beads and are not affected, and smaller things like electrolytes pass directly, said Dr. Phillip Chan, managing director of CytoSorbents Corporation, which manufactures the device. CytoSorb can also eliminate certain proteins that the body needs.
But “in a potentially deadly disease when you have a cytokine storm,” said Dr. Chan, “it’s more or less a race to eliminate what will kill you against the temporary inconvenience of removing things from your body.” manufactures all the time anyway. “
In Europe, where CytoSorb has been marketed since 2013, it has been used more liberally. In the United States, the device was only authorized for patients who had exhausted all other options. Even now, during the pandemic, its use is only allowed in critically ill coronavirus patients with imminent or confirmed respiratory failure.
Dr. Stephan Ziegeler, who heads a specialized pulmonary intensive care unit at a hospital in Ibbenbüren, Germany, has so far treated eight people with CytoSorb. (Since 2018, he has received speaking fees from the manufacturer of CytoSorb, totaling 5,000 euros, or approximately $ 5,600). Of these, three have been released, three are in the process of being weaned from ventilation and two have died.
Bacterial septicemia patients typically need a maximum of three cartridges – one a day at $ 1,200 – but coronavirus patients have such astronomical levels of cytokines, said Dr. Ziegeler, that some have needed dozens of cycles, with two fresh cartridges per day.
“It looks like Covid-19 has a prolonged cytokine storm – a prolonged and truly effective inflammatory state compared to other sepsis states,” he said.