1 research outputs found
Coupled plasma filtration and adsorption in septic shock: a multicentric experience
Introduction Recently extracorporeal removal of mediators and endotoxins improved haemodynamics, organ dysfunction and mortality in patients with abdominal sepsis [1]. Coupled plasma filtration and adsorption (CPFA), too, may improve haemodynamics, respiratory function and mortality through removal of proinfl ammatory mediator. The aim of this multicentric study is to evaluate the haemodynamic response and the respiratory function, and to evaluate the reduction of infl ammatory markers during CPFA.Methods Fifty-fi ve septic patients were enrolled in this study. Every patient
had four CPFA treatments (LINDA; Bellco-Mirandola, Italy) for 8 hours with
Qb = 200 ml/minute, Qultrafi ltration
= 30 ml/kg/hour and Qplasma = 20% of Q
b. At T0 (basal), T1 (after fi rst cycle), T2 (after second cycle), T3 (after third cycle)and T4 (after fourth cycle) we evaluated haemodynamic parameters,
norepinephrine dosage, PaO2/FiO
2 ratio, plasma IL-6, and procalcitonin (PCT). The ANOVA test was used to compare changes during times study. P <0.05 was considered statistically significant.
Results Patients enrolled in the study have been submitted to 256 CPFA
treatments for 2,650 hours. Table 1 presents the main results of the study.
IV quartile of IL-6 is shown in Table 1Conclusions In this large multicentric study, CPFA may improve
haemodynamic status and respiratory function. Plasma fi ltration and
adsorption of proinfl ammatory mediators may explain this improvement.
Larger randomized controlled trials are indicated to confi rm these data.
Reference
1.Cruz D, et al.: JAMA 2009, 23:2445-2452