Systematic review with expert consensus on use of extracorporeal hemoadsorption in septic shock: An Indian perspective

Table 1 Consensus statement and summary of overall agreement

Questions	Responses, n = 11 (%)		Consensus status - overall agreement
	Agreed/yes (%)	Disagreed/no (%)
Q1. Is there a need for adjuvant therapy in the management of refractory septic shock patients, when standard of care is insufficient?	10 (90.91)	1 (9.09)	A total of 90.91% experts agreed on the need for adjuvant therapy in the management of refractory septic shock patients, when the standard of care is insufficient. (Consensus Achieved)
Q2. In case of refractory septic shock cycle, CytoSorb® ideally be initiated within a maximum of 24 h after diagnosis and start of standard therapy	11 (100)	0 (0)	All experts (100%) agreed that in refractory septic shock cycle, CytoSorb® ideally be initiated within a maximum of 24 h after diagnosis and start of standard therapy. (Consensus Achieved)
Q3. IL-6 levels are not a mandatory parameter to decide on using CytoSorb® therapy in refractory septic shock patients	10 (90.91)	1 (9.09)	A total of 90.91% experts agreed that IL-6 levels are not a mandatory parameter to decide on using CytoSorb® therapy in refractory septic shock patients. (Consensus Achieved)
Q4. There are patients who may require more than one CytoSorb® adsorber to achieve sufficient haemodynamic stabilization	10 (90.91)	1 (9.09)	A total of 90.91% experts agreed that there are patients who may require more than one CytoSorb® adsorber to achieve sufficient haemodynamic stabilization. (Consensus Achieved)
Q5. If you want to continue with CytoSorb® therapy, the absorber should be changed after 6-24 h depending on the clinical course and the machine type availability	11 (100)	0 (0)	All experts (100%) agreed that if CytoSorb® therapy is continued, the absorber should be changed after 6-24 h depending on the clinical course and the machine type availability. (Consensus Achieved)
Q6. CytoSorb® therapy is generally a safe therapy	10 (90.91)	1 (9.09)	A total of 90.91% experts agreed that CytoSorb® is generally a safe therapy. (Consensus Achieved)
Q7. Sepsis-induced AKI requiring RRT is no prerequisite to initiate CytoSorb® therapy in refractory septic shock patients	11 (100)	0 (0)	All experts (100%) agreed that sepsis-induced AKI requiring RRT is not a prerequisite to initiate CytoSorb® therapy in refractory septic shock patients. (Consensus Achieved)
Q8. Evaluation of the efficacy of CytoSorb® therapy should be based on more proximal endpoints like haemodynamic stabilization, inflammatory biomarkers, and/or improvement in the organ function instead of mortality	10 (90.91)	1 (9.09)	A total of 90. 91% experts agreed that the evaluation of the efficacy of CytoSorb® therapy should be based on endpoints like haemodynamic stabilization, inflammatory biomarkers, and/or improvement in the organ function instead of mortality. (Consensus Achieved)
Q9. Do you think this flowchart can be helpful to a doctor very new to the therapy to ensure a certain level of best practice?	11 (100)	0 (0)	All experts (100%) agreed on the (revised) flowchart for doctor who are new to the therapy to ensure a certain level of best practice. (Consensus Achieved)

AKI: Acute kidney injury; RRT: Renal replacement therapy.