2021
DOI: 10.1007/s00134-021-06501-3
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High dose coupled plasma filtration and adsorption in septic shock patients. Results of the COMPACT-2: a multicentre, adaptive, randomised clinical trial

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Cited by 52 publications
(31 citation statements)
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“…Hemoadsorption techniques act on high concentrations of mediators and therefore re-establish the principle of immune homeostasis by "modulating the peaks" of pro-and anti-inflammatory mediators without affecting the important role of physiologic concentrations. 11 Finally, the concept of a "therapeutic dose" of CPFA applied in COMPACT-2 based on plasma-separation and plasma-adsorption sessions ⩾0.2 L/kg is not comparable to that which has emerged from the literature in the The International Journal of Artificial Organs 45 (7) recent years for whole blood hemoperfusion based either on a more frequent cartridge change in a given time frame or on the ratio of purified blood flow/time/body surface. 12,13 As today only low level of evidence exists on blood purification in septic shock, but what we know should be used at the best of our knowledge to "first do not harm" (Figure 1) (Table 1).…”
mentioning
confidence: 99%
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“…Hemoadsorption techniques act on high concentrations of mediators and therefore re-establish the principle of immune homeostasis by "modulating the peaks" of pro-and anti-inflammatory mediators without affecting the important role of physiologic concentrations. 11 Finally, the concept of a "therapeutic dose" of CPFA applied in COMPACT-2 based on plasma-separation and plasma-adsorption sessions ⩾0.2 L/kg is not comparable to that which has emerged from the literature in the The International Journal of Artificial Organs 45 (7) recent years for whole blood hemoperfusion based either on a more frequent cartridge change in a given time frame or on the ratio of purified blood flow/time/body surface. 12,13 As today only low level of evidence exists on blood purification in septic shock, but what we know should be used at the best of our knowledge to "first do not harm" (Figure 1) (Table 1).…”
mentioning
confidence: 99%
“…Although the authors point to potential risks associated with both CytoSorb hemoperfusion and Coupled Plasma Filtration Adsorption (CPFA) based on the results of the COMPACT-2 study, 7 the two extracorporeal purification techniques are not comparable: CPFA works intermittently compared to continuous 24-h hemoperfusion with CytoSorb, and CPFA requires the additional process of plasma-separation before adsorption, whereas CytoSorb adsorption is performed on whole blood without plasma-separation.…”
mentioning
confidence: 99%
“…tomto kontextu nelze nezmínit studii COMPACT-2[73]. Jednalo se o multicentrickou randomizovanou studii z prostředí italských JIP, která měla za cíl sledovat efekt párové plazmafiltrace adsorpce (CPFA, coupled plasmafiltration adsorption) u pacientů v septickém šoku.…”
unclassified
“…Jednalo se o multicentrickou randomizovanou studii z prostředí italských JIP, která měla za cíl sledovat efekt párové plazmafiltrace adsorpce (CPFA, coupled plasmafiltration adsorption) u pacientů v septickém šoku. Jedná se o další metodu extrakorporálního očišťování krve, kdy je krev "očištěna" v zásobníku se styrenovou pryskyřicí a následně ještě v klasickém hemofiltru.Proponenti této metody opět argumentují neselektivní schopností CPFA eliminovat plejádu pro-i protizánětlivých cytokinů, a tím příznivě ovlivnit průběh septického šoku, a to přestože již první studie COMPACT byla z tohoto pohledu zklamáním a neprokázala žádný benefit[74].Ve studii COMPACT-2[73] bylo využito nového přístroje pro CPFA se schopností regionální citrátové antikoagulace a s potenciálem vyššího objemu očištěné krve. Randomizováni byli pacienti s diagnózou nově vzniklého septického šoku.…”
unclassified
“…Garbero et al report the results of the COMPACT-2 trial investigating high volume coupled plasma filtration and adsorption (CPFA) in 115 patients suffering from septic shock [1]. The study was prematurely determined due to a potential harmful effect of CPFA as mortality in the intensive care unit (ICU) was 54% in the treatment and 29% in the control group.…”
mentioning
confidence: 99%