The role of cytokine adsorption in post-cardiac arrest syndrome (PCAS): a 10-year literature narrative review.

BACKGROUND

Post-cardiac arrest syndrome (PCAS) is a critical condition arising from systemic inflammation and ischemia-reperfusion injury, often leading to poor outcomes despite advanced supportive therapies. Cytokine adsorption has been proposed as a therapeutic approach to mitigate the inflammatory response and improve survival and recovery in PCAS patients.

MATERIALS AND

METHODS

This narrative review aims to synthesize and critically evaluate recent literature (2013-2024) on the role of cytokine adsorption in PCAS management, focusing on inflammatory modulation, clinical outcomes, and safety. A comprehensive search of PubMed, Cochrane Library, Embase, Medline Complete, Scopus and Web of Science identified 17 studies investigating cytokine adsorption in PCAS. Inclusion criteria encompassed clinical trials, observational studies, and preclinical investigations.

RESULTS

Cytokine adsorption reduces inflammatory markers, particularly interleukin-6 (IL-6), in patients with PCAS. While some studies report modest improvements in hemodynamic stability and reduced vasopressor requirements, survival benefits remain inconsistent across the literature.

CONCLUSIONS

Cytokine adsorption appears to be a safe and feasible intervention in PCAS, with potential benefits in inflammatory modulation and hemodynamic support. However, its impact on long-term survival and neurological recovery remains unclear. Future large-scale randomized controlled trials are needed to establish definitive clinical guidelines for its use in PCAS management.