In this pilot study of patients with CS requiring VA-ECMO, the application of an oXiris did not demonstrate a significant reduction in endotoxin levels at 48 h compared with standard care.

While we observed temporal decreases in IL-6 and GDF-15 levels in oXiris group, these changes did not translate into statistically significant improvements in clinical outcomes.

Our results provide a foundation for further research, suggesting that larger-scale studies are warranted to further investigate the potential benefits and optimal application of extracorporeal endotoxin and cytokine removal in patients with advanced forms of CS.

In this prospective, single-center, randomized, open-label pilot trial, 40 patients with CS who were undergoing VA-ECMO were randomly assigned to receive either oXiris for 24 h (n = 20) or usual care (n = 20).

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