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Janina Praxenthaler, Elke Ute Schwier, Simon Altmann, Carmen Kirchner, Julian Bialas, Dietrich Henzler, Thomas Köhler

• Background: Sepsis is often associated with liver dysfunction, which is an indicator of poor outcomes. Specific diagnostic tools that detect hepatic dysfunction in its early stages are scarce. So far, the immune modulatory effects of hemoadsorption with \(CytoSorb^{®}\) on liver function are unclear. Method: We assessed the hepatic function by using the dynamic \(LiMAx^{®}\) test and biochemical parameters in 21 patients with sepsis or septic shock receiving \(CytoSorb^{®}\) in a prospective, observational study. Points of measurement: T\(_1\): diagnosis of sepsis or septic shock; T\(_2\) and T\(_3\): 24 h and 48 h after the start of \(CytoSorb^{®}\); T\(_4\): 24 h after termination of \(CytoSorb^{®}\). Results: The hepatic biotransformation capacity measured by \(LiMAx^{®}\) was severely impaired in up to 95 % of patients. Despite a rapid shock reversal under \(CytoSorb^{®}\), a significant improvement in \(LiMAx^{®}\) values appeared from T\(_3\) to T\(_4\). This decline and recovery of liver function were not reflected by common parameters of hepatic metabolism that remained mostly within the normal range. Conclusions: Hepatic dysfunction can effectively and safely be diagnosed with \(LiMAx^{®}\) in ventilated ICU patients under \(CytoSorb^{®}\). Various static liver parameters are of limited use since they do not adequately reflect hepatic dysfunction and impaired hepatic metabolism.