CytoSorb® as the Rescue Therapy of Acute Respiratory Distress Syndrome and Shock in a Case of Severe Pancreatitis

unit (ICU) and continued on NIV care with an FiO 2 of 0.85/positive end-expiratory pressure (PEEP) of 10, and had a P/F ratio of 102.He gradually developed severe hypotension, and his respiratory distress worsened.By 4 hours in the ICU, his FiO 2 was increased to 100%, P/F ratio was 77, and he was receiving triple inotropes: norepinephrine at 1.5 g/kg/minute, epinephrine at 0.3 g/kg/ minute, and vasopressin at 2.4 units/hour.He was intubated and mechanically ventilated with titrated analgo-sedation and continued on triple inotropes with protocolized ICU monitoring.In the next 8 hours, he had a P/F ratio of 56.2, was anuric with severe metabolic acidosis.He was started on CRRT run in CVVHDF.In view of worsening respiratory patterns, increasing hemodynamic instability, and multiorgan involvement with uncontrolled inflammatory response and a CYTOSCORE of >10, a decision was made to use CytoSorb therapy with protocolized 1,