AUTHOR=Kovacevic Pedja , Dragic Sasa , Jandric Milka , Momcicevic Danica , Malesevic Vedrana , Kovacevic Tijana , Matejic-Spasic Marijana , Knezevic Tanja , Zlojutro Biljana TITLE=Does adjunctive hemoadsorption provide benefit in the management of ischemia–reperfusion syndrome following near-drowning? A case report JOURNAL=Frontiers in Medicine VOLUME=11 YEAR=2024 URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1341156 DOI=10.3389/fmed.2024.1341156 ISSN=2296-858X ABSTRACT=

Drowning remains a significant global health concern, claiming over 300,000 lives annually, with a disproportionate impact on young individuals in low-and middle-income countries. Conventional mechanical ventilation, while common, falls short in addressing the hypoxemia and hypercapnia often observed in severe near-drowning cases. Veno-venous extracorporeal membrane oxygenation (vvECMO) emerges as a critical intervention for cardiopulmonary failure post-drowning. This case report delves into the pivotal role of ischemia–reperfusion injury (IRI) in a near-drowning-related pathology. Following the initial insult, reoxygenation exacerbates the inflammatory cascade, resulting in a surge of pro-inflammatory mediators. In this context, CytoSorb®, a hemoadsorption cartridge, demonstrates promise by effectively removing these mediators from circulation. This report outlines its application in a critically ill adolescent patient who experienced near-drowning, presenting a compelling case for CytoSorb as an adjunctive therapy in managing IRI-induced hyperinflammation.