Abstract: Acute respiratory distress syndrome (ARDS) is a severe clinical condition characterized
by acute respiratory failure and a high mortality risk despite conventional mechanical ventilatory
support. Veno-venous extracorporeal membrane oxygenation (vvECMO) has emerged as an effective
life-support technology for patients with ARDS. However, complications may arise following the
decannulation of vvECMO, with a relatively frequent development of systemic hyperinflammation
(SHI). Among the various treatment strategies for SHI, the use of hemoadsorption with CytoSorb®
has shown promising results in removing excessive levels of cytokines and attenuating the hyperinflammatory
response. In this case series, we present three critically ill patients with ARDS secondary
to pneumonia who underwent vvECMO and subsequently received prophylactic hemoadsorption
with CytoSorb® following decannulation as a part of our clinical practice. This case series aims to
describe the potential positive effects of hemoadsorption in preventing the development of SHI after
vvECMO decannulation in ARDS patients.
