Different effect of CVVHDF and coupled plasma filtration and adsorption on IL-6 and procalcitonin in sepsis

Turani, Franco; Falco, M; Barchetta, R; Candidi, F; Marinelli, Alessandro; Corato, C Di

doi:10.1186/cc9537

Cited by 3 publications

(3 citation statements)

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“…dall'analisi dei risultati emerge che la mortalità al 28° giorno risulta del 36.9%, a fronte di una predetta probabilità media di morte intraospedaliera del 75%, stimata secondo il sistema di classificazione SAPS II. Inoltre, la percentuale di mortalità per sepsi osservata risulta inferiore rispetto a quella da noi osservata in un precedente lavoro che era pari al 51% dei pazienti trattati (12) e rispetto a quella riportata dal GiViTi, che era pari al 65.3% (13). Si sono osservati anche un significativo miglioramento del SOFA score (da 15±2 a 12±3), indice del danno multiorgano, e un miglioramento significativo di alcuni parametri emodinamici sistemici come la pressione arteriosa media (da 62±5 a 73±2, p<0.05), con conseguente riduzione progressiva della terapia con ammine vasoattive.…”

Section: Discussioneunclassified

Experience of Apheresis in the Intensive Care Unit

Splendiani

Turani

Noce

et al. 2013

Giornale di Tecniche Nefrologiche e Dialitiche

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Introduction Sepsis is one of the main causes of death in critically ill patients worldwide, and in many cases it is associated with renal and/or other organ failure. However, we do not have an efficient therapy to reduce its extremely high mortality rate. In the last years the interest around the use of extracorporeal blood purification techniques has increased. One of the emerging treatments in patients with severe sepsis and septic shock is coupled plasma filtration adsorption (CPFA). CPFA is a novel extracorporeal blood purification therapy aimed at non-selectively reducing the circulating levels and activities of both pro and anti-inflammatory mediators. The aim of this study, conducted in septic patients, was to observe the effects of CPFA on mortality and several laboratory and hemodynamic parameters. Patients and Methods We treated 65 patients (50 males and 15 females) with CPFA. We then analysed the mean arterial pressure (MAP), the sequential organ failure assessment (SOFA) score, and the acute physiology and chronic health evaluation II (APACHE II) score. Serum levels of interleukin-6 and procalcitonin were also measured. Results After 28 days we observed a mortality of 36.9% (24 patients) and a significant reduction in IL-6, procalcitonin, SOFA and APACHE scores. Conclusion CPFA represents a promising new approach for blood purification in sepsis.

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Section: Discussioneunclassified

Experience of Apheresis in the Intensive Care Unit

Splendiani

Turani

Noce

et al. 2013

Giornale di Tecniche Nefrologiche e Dialitiche

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“…In the other trial, Mao et al (2009) demonstrated the ability of CPFA to effectively eliminate inflammatory mediators with an immunomodulatory effect (decreased TNF-α was accompanied by growing IL-1 receptor antagonist (IL-1RA) [29]. …”

Section: Discussionmentioning

confidence: 99%

“…Many trials demonstrated a significant reduction of cytokine concentrations after the selective adsorption of endotoxin [18,25,26] and CPFA [27,28,29]. …”

Section: Discussionmentioning

confidence: 99%

A Pilot Study of Selective Lipopolysaccharide Adsorption and Coupled Plasma Filtration and Adsorption in Adult Patients with Severe Sepsis

Yaroustovsky¹,

Abramyan²,

Кротенко³

et al. 2015

Blood Purif

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Aim: To evaluate the safety and effectiveness of combined extracorporeal therapy in patients with severe sepsis after cardiac surgery. Materials and Methods: Twenty patients received combined extracorporeal therapy (LPS-adsorption with Toraymyxin columns + CPFA). The inclusion criteria were clinical signs of severe sepsis, EAA = 0.6, and PCT >2 ng/ml. 20 comparable patients in the control group received only standard therapy. Results: Each patient in the study group received 2 daily treatments of combined extracorporeal therapy. In contrast to controls, we noted an increase in the values of MAP from 73 to 82 mm Hg, (p < 0.001) and the mean oxygenation index (from 180 to 246, p < 0.001), decrease of EAA from 0.77 to 0.55, p < 0.001, and PCT (from 6.23 to 2.83 ng/ml, p < 0.001). The 28-day survival rate was 65 and 35% in the study and control groups respectively, p = 0.11. Conclusion: The combined use of LPS-adsorption and CPFA in a single circuit with standard therapy is a safe and possibly effective adjunctive method for treating severe sepsis.

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Recent Advances in Extracorporeal Therapies

Shah

2013

Apollo Medicine

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Polymyxin BHigh cut off (HCO) membranes Cytokine binding therapies a b s t r a c t Continuous renal replacement therapies (CRRT) started as continuous arterio-venous hemodialysis (CAVH) 2 in the 1970s. Since then, the last 4 decades have seen numerous improvements in extracorporeal therapies. Some of the notable improvements have been the development of veno-venous therapies, the development of special low resistance filters with special geometry and fibers and improved machine safety with the use of microprocessors and sensors.Classic extracorporeal therapies have focused on the removal of small solutes for efficacy. However, it is well known that the characteristics of some solutes make their removal difficult. Also, limitations in efficiency of dialysis membranes, advances in hemadsorption and the development of newer filters have led to the application of extracorporeal therapies in the management of patients with multi-organ failure and sepsis, refractory congestive heart failure, acute neurologic injury, liver failure and patients with various other ailments.

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Different effect of CVVHDF and coupled plasma filtration and adsorption on IL-6 and procalcitonin in sepsis

Cited by 3 publications

References 1 publication

Experience of Apheresis in the Intensive Care Unit

Experience of Apheresis in the Intensive Care Unit

A Pilot Study of Selective Lipopolysaccharide Adsorption and Coupled Plasma Filtration and Adsorption in Adult Patients with Severe Sepsis

Recent Advances in Extracorporeal Therapies

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