Coupled plasma filtration adsorption for the treatment of sepsis or septic shock: a systematic review and meta-analysis

Abstract

Background The effect of coupled plasma filtration adsorption (CPFA) for the treatment of sepsis or septic shock is controversial. A systematic review and meta-analysis was performed to evaluate the impact of CPFA on all-cause mortality in patients with sepsis or septic shock. Methods We searched the PubMed, Cochrane, and Embase databases for randomized controlled trials (RCTs) and cohort studies from inception to the 1st of May 2022. We included studies involving patients (˃ 14 years) with sepsis or septic shock. All authors reported our primary outcome of all-cause mortality (hospital mortality, 28-day mortality or 30-day mortality). Results were expressed as odds ratio (OR) with accompanying 95% confidence interval (CI). Results Six studies including 537 patients were included. The primary outcome of this meta-analysis showed that the all-cause mortality was about 54.2% (119/243 in the CPFA group and 172/294 in the control group). There was no statistically significant difference in the all-cause mortality between two groups (odds ratio [OR] = 0.75; 95% CI 0.53 to 1.06; P = 0.11; Chi2 = 14.04; I2 = 64%). Conclusions The treatment of CPFA failed to decrease all-cause mortality of sepsis or septic shock patients. Further large-scale randomized controlled trials (RCTs) evaluating the ability of this therapy to improve clinical outcomes are still required to confirm these results.

Diagnostic and prognostic value of heparin-binding protein in sepsis: A systematic review and meta-analysis

“…These results suggest that these biomarkers may be equally effective in diagnosing sepsis. [23,69] In a study by Liu et al, [70] it was found that single PCT measurements at admission and non-clearance PCT had moderate prognostic accuracy and were significantly linked to all-cause mortality in septic patients. The sensitivity for single PCT measurement and non-clearance PCT were 76% and 72%, respectively, with corresponding specificities of 64% and 77%.…”

Septic Hyperinflammation—Is There a Role for Extracorporeal Blood Purification Techniques?

“…As the COMPACT-2 trial found significantly increased mortality in the therapy group within the first 72 h of study inclusion, this finding ultimately led to the discontinuation of ROMPA [ 85 , 86 ]. Currently, no other studies are known to investigate the effect of CPFA in sepsis therapy, and it seems unlikely that CPFA will be used in sepsis therapy in the future [ 44 ].…”

Nomenclature of Extracorporeal Blood Purification Therapies for Acute Indications: The Nomenclature Standardization Conference

“…The second part consists of the CRRT, which can then be used to remove small toxins not adsorbed by the resin or to remove fluid. Plasma filtration adsorption dialysis is proposed for inflammatory states with AKI [31]. Plasma filtration adsorption can be combined with dialysis in series or in a single device [32].…”