Usage of oXiris hemofilter for septic shock patients: a single-center experience
Chun Zhang, Borui Sun, Ting Lin, Wenjing Wang, Yufeng Jin, Sinan Liu, Jingyao Zhang, Zheng Wang, Chang Liu
Abstract
ObjectiveTo evaluate the efficacy and safety of oXiris hemofilter for septic shock patients.
MethodsClinical data of septic shock patients receiving continuous renal replacement therapy (CRRT) with oXiris hemofilter in department of surgical intensive care unit (SICU) of the First Affiliated Hospital of Xi'an Jiaotong University from March 1st, 2018 to July 20th, 2019 were retrospectively analyzed. The heart rate (HR), mean arterial pressure (MAP), oxygenation index (PaO2/FiO2), lactate (Lac), platelet count (PLT), serum procalcitonin (PCT), interleukin-6 (IL-6) and C-reactive protein (CRP), noradrenaline (NE) dosage, acute physiology and chronic health evaluationⅡ(APACHEⅡ) and sequential organ failure score (SOFA) were compared before and after oXiris treatment and the prognosis were also analyzed.
ResultsSix patients with septic shock were included [5 males, the average age was (56.3±11.8) years old]. A total of 13 oXiris hemofilter sets were performed during treatment. Compared with before treatment, the HR, IL-6 and CRP levels were significantly decreased after treatment [HR (bpm): 93.8±9.7 vs. 133.5±18.3, IL-6 (ng/L): 509.2±169.6 vs. 3 739.8±618.2, CRP (mg/L): 169.1±148.3 vs. 277.8±68.7, all P < 0.05], MAP, PaO2/FiO2 and PLT were significantly increased [MAP (mmHg, 1 mmHg = 0.133 kPa): 73.3±2.2 vs. 63.3±1.6, PaO2/FiO2 (mmHg): 166.8±40.4 vs. 95.1±56.2, PLT (×109/L): 73.3±27.5 vs. 41.2±21.4, all P < 0.05]; meanwhile, NE dosage, APACHEⅡ and SOFA scores were significantly decreased [NE (μg·kg-1·min-1): 0.4±0.3 vs. 1.2±0.7, APACHEⅡ: 18.8±6.9 vs. 30.0±7.3, SOFA: 11.7±4.2 vs. 17.3±2.1, all P < 0.05]. Although Lac and PCT decreased after treatment, there was no significant difference [Lac (mmol/L): 3.5±2.1 vs. 6.1±3.2, PCT (μg/L): 37.7±48.3 vs. 85.1±32.8, both P > 0.05]. At the end, 3 of the 6 patients survived and the others were discharged again medical advice. The length of SICU stay was 3 to 23 days, with an average of (13.0±8.5) days. No adverse events occurred during the treatment.
ConclusionoXiris hemofilter can effectively remove inflammatory mediators in circulation, significantly improve hemodynamic status and severity, and may be considered as a safe and reliable treatment modality for septic shock patients.
Key words:
Septic shock; Endotoxin; Blood purification
Contributor Information
Chun Zhang
Department of SICU, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
Borui Sun
Department of Anesthesiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
Ting Lin
Department of SICU, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
Wenjing Wang
Department of SICU, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
Yufeng Jin
Department of SICU, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
Sinan Liu
Department of SICU, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
Jingyao Zhang
Department of SICU, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
Zheng Wang
Department of SICU, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
Chang Liu
Department of SICU, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China