Investigation of CytoSorb cytokine and myoglobin removal in the treatment of trauma

Polytrauma is the leading cause of military casualties and is a potent trigger of the immune response. Tissue damage, infection, burns, hemorrhage, ischemia and reperfusion, and cell necrosis triggers the immune system to produce excessive levels of cytokines, often called cytokine storm, that can directly kill cells, damage organs, and cause severe inflammation that ultimately leads to multiple organ failure and death in many patients. In severe trauma, crush injury can further cause the breakdown of skeletal muscle, called rhabdomyolysis, and the vast release of myoglobin that can then injure the kidneys and cause renal failure, an independent risk factor for death. Finally, cytokine storm can also disable the immune system, putting patients at high risk of secondary infections. Because of this, multiple organ failure and infection are two of the main causes of late death in trauma patients, yet remains a problem. In this submission, we propose the development of a portable, self-contained, hemoperfusion system that uses our CytoSorb cytokine and myoglobin filter, to prevent or mitigate organ injury in a porcine model of trauma. If successful, this novel therapy could help improve survival of our warfighters and civilians alike, while reducing healthcare costs.