Table 1.

Best practice suggestions for the use of CytoSorb in septic/vasoplegic shock.

Patient Selection	Consider in refractory septic/vasoplegic shock unresponsive to SOC (CytoScore > 6) [42]. Patients should have obvious signs of ongoing hyperinflammation. If available, soluble markers of inflammation should be clearly elevated (e.g., Il-6, PCT, ferritin).
Timing	Start within 12 but not later than 24 h after diagnosis of septic/vasoplegic shock.
Dosing	Change adsorber every 8–12 h during the first day or two of therapy. Later, change the adsorber every 24 h. Maintain therapy until hemodynamic stabilization (e.g., NE dose < 0.05 µg/kg/min) is reached.
Concomitant Medication	For drugs prone to adsorption (including anti-infectives), consider increased loading doses and/or additional doses after 1–2 h after initiation of CytoSorb therapy [54,55]. Therapeutic drug monitoring (TDM) at regular intervals is recommended if available.

SOC, standard of care. Il-6, interleukin 6. PCT, procalcitonin. NE, norepinephrine.