Continuous hemodiafiltration with a cytokine-adsorbing hemofilter in patients with septic shock: a preliminary report.

Abstract

BACKGROUND/AIM:

We investigated the clinical efficacy of continuous hemodiafiltration (CHDF) with AN69ST hemofilter (AN69ST-CHDF) in patients with septic shock.

MATERIALS AND METHODS:

A prospective, multicenter, single-arm study was conducted. Patients with sepsis and shock defined by hyperlactemia were enrolled. The patients were treated with CHDF and in accordance with the Surviving Sepsis Campaign guidelines (SSCG).

RESULTS:

Thirty-four patients were enrolled. On ICU admission, the mean blood IL-6 level was 44,800 ± 77,700 pg/ml, and the mean blood lactate level was 69.0 ± 49.4 mg/dl. Both the mean blood IL-6 and lactate levels had significantly decreased to normal ranges after 72 h of AN69ST-CHDF. Though the mean APACHE II score was 32.7 ± 9.8, 28-day survival was 73.5%.

CONCLUSION:

The current study suggested that adding AN69ST-CHDF to the treatments outlined in the SSCG might lead to good outcomes for patients with septic shock, probably via the removal of cytokines from the bloodstream.

• Authors: Hidetoshi Shiga, Hiroyuki Hirasawa, Osamu Nishida, Shigeto Oda, Masataka Nakamura, Kunihiro Mashiko, Kenich Matsuda, Nobuya Kitamura, Yoshihiko Kikuchi, Nobuo Fuke
• Journal: Blood purification (Blood Purif) Vol. 38 Issue 3-4 Pg. 211-8 ( 2014) ISSN: 1421-9735 [Electronic] Switzerland
• PMID: 25531978 (Publication Type: Clinical Trial, Journal Article, Multicenter Study)
• Copyright: © 2014 S. Karger AG, Basel.

Chemical References

• Acrylic Resins
• Catecholamines
• Cytokines
• IL6 protein, human
• Interleukin-6
• Lactates
• Membranes, Artificial
• AN-69
• Acrylonitrile

Topics

• APACHE
• Acrylic Resins
• Acrylonitrile (analogs & derivatives)
• Aged
• Aged, 80 and over
• Blood Pressure
• Catecholamines (blood)
• Cytokines (blood)
• Female
• Hemodiafiltration (instrumentation, methods)
• Humans
• Interleukin-6 (blood)
• Kaplan-Meier Estimate
• Lactates (blood)
• Male
• Membranes, Artificial
• Middle Aged
• Prospective Studies
• Shock, Septic (blood, mortality, therapy)
• Survival Rate
• Treatment Outcome