Study of CytoSorb Device Treatment in Adults with Acute on Chronic Liver Failure Comparing Standard Care Plus CytoSorb to Standard Care Alone

What this Trial Is About

Researchers are investigating the effects of CytoSorb hemoadsorption therapy on patients with Acute on Chronic Liver Failure ACLF grades 2 and 3. The study aims to evaluate changes in bilirubin and ammonia levels during treatment, as well as the development and prevalence of muscle loss sarcopenia using ultrasound and handgrip strength measurements. Additionally, the study compares two anticoagulation methods for patients receiving Continuous Renal Replacement Therapy CRRT. Patients with ACLF receiving CytoSorb treatment will undergo therapy for 72 hours to help remove molecules driving systemic inflammation. The study includes a historical control group that received only standard medical care. The first group of patients on CRRT will receive Low Molecular Weight Heparin LMWH anticoagulation, while the second group will receive regional citrate anticoagulation RCA, with monitoring of anti-Xa levels. Participants will be closely monitored through muscle ultrasounds, blood tests measuring bilirubin, ammonia, bile acids, and inflammatory markers, as well as clinical assessments including hepatic encephalopathy grading, hemodynamic profiles, and renal function. Outcome measures will be recorded at various time points up to 90 days after enrollment. The study also tracks mortality and ventilation status, aiming to better understand treatment effects and muscle status in this critically ill group.

COOLEY- Study: aCute On chrOnic Liver failurE Using the cYtosorb Device