Standard renal replacement therapy combined with hemoadsorption in the treatment of critically ill septic patients

Ther Apher Dial. 2021 Oct;25(5):663-670. doi: 10.1111/1744-9987.13612. Epub 2021 Jan 12.

Abstract

The aim of the study was to assess clinical and paraclinical effects of hemoadsorption on organ dysfunction, severity scores, and 28-day survival in septic patients. Fifty-five septic patients admitted to a general intensive care unit of a university hospital were included in the present study. Each patient underwent three consecutive 24-hour sessions of renal replacement therapy in combination with hemoadsorption. Clinical and paraclinical variables were measured after the treatment and severity scores were calculated. The use of hemoadsorption was associated with an increase in arterial partial pressure of oxygen/fraction of inspired oxygen ratio (P = .02), urine output (P = .01), and Glasgow Coma Score (P = .03) and a decrease in white blood cell count (P = .03), C-reactive protein (P = .01), procalcitonin (P = .01) levels, and platelet count (P = .01). The use of hemoadsorption was associated with an improvement in neurological and renal functions and a decrease in inflammatory markers. Acute respiratory distress syndrome improved significantly based on relevant improvements in one-third of the patients.

Keywords: hemoadsorption; organ dysfunction; renal replacement therapy; sepsis.

MeSH terms

  • Critical Care / methods*
  • Critical Illness
  • Female
  • Hemoperfusion / methods*
  • Humans
  • Male
  • Middle Aged
  • Organ Dysfunction Scores
  • Patient Acuity
  • Prospective Studies
  • Renal Replacement Therapy / methods*
  • Romania / epidemiology
  • Sepsis / mortality*
  • Sepsis / physiopathology
  • Sepsis / therapy*
  • Survival Analysis
  • Treatment Outcome