Abstract
Background: A cytokine storm can lead to organ dysfunction and death in critically ill children. Extracorporeal hemoperfusion aims to reduce hyperinflammation by filtering out mid-range cytokines (e.g., IL-6), but pediatric data remain limited. Methods: We conducted a narrative review with PRISMA-guided screening of PubMed, Scopus, and Google Scholar for pediatric reports of HA330/HA380 from January 2020 to June 2025. Due to heterogeneity in populations, circuits, and outcome timing, the results were synthesized descriptively. Three studies met the inclusion criteria: a prospective series of 12 patients with septic shock using HA330, a single case of a pediatric heart transplant with HA380 during cardiopulmonary bypass, and a retrospective comparative cohort study of Pediatric Intensive Care Unit (PICU) oncology patients on continuous renal replacement therapy (CRRT) comparing HA330 (n = 11) versus CytoSorb (n = 10). Results: Three studies involving 23 pediatric patients were analyzed. The median age was 8 years, and 56.5% of patients were male. Most patients underwent hemoadsorption with HA330 via continuous renal replacement therapy (CRRT) or continuous venovenous hemodiafiltration (CVVHDF). Post-treatment reductions were noted in interleukin-6 (IL-6) (mean -69.6%), C-reactive protein (CRP) (-59.0%), and procalcitonin (PCT) (-70.4%). Severity scores (Pediatric Logistic Organ Dysfunction-2 (PELOD-2), Pediatric Risk of Mortality-3 (PRISM-3), and Pediatric Sequential Organ Failure Assessment (pSOFA) improved significantly (p = 0.002). The mean PICU stay was 15.6 days. The survival rate was 87%, and no hemoadsorption-related adverse events were reported. Conclusions: HA330/380 hemoadsorption is a safe and potentially effective treatment for pediatric cytokine storms, reducing inflammation and improving clinical status. However, larger, standardized studies are needed to confirm these findings and guide clinical use.