Cytosorb use in postoperative treatment of a patient with infective endocarditis

We report of a 39 years old male patient who was admitted to hospital for a surgical treatment of endocarditis of the prosthetic aortic valve. Just after surgery, he had developed a severe inflammatory response with acute kidney and liver injury. Because of that, beside the usual therapy, on the second postoperative day, continuous renal replacement therapy (CRRT) started in CVVHDF mode with hemadsorption using Cytosorb. The Cytosorb therapy is based on an extracorporeal blood purification that reduces excessive levels of inflammatory mediators. After 5 days of CRRT and Cytosorb therapy patient was stable, extubated, with normal kidney and liver function. On the next day, patient was unstable again with significant leukocytosis. Performed reoperation was done due to cardiac tamponade and after that CRRT and Cytosorb therapy were re-established. A few hours later patient was hemodynamically stable. Summary: The Cytosorb treatment can be very useful in postoperative treatment of acute kidney injury and sepsis in patients after the surgical treatment of bacterial endocarditis