Survival benefit of resin cartridge extracorporeal blood purification therapy in patients with septic shock
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Date
2024
Journal Title
Journal ISSN
Volume Title
Publisher
Turkiye Klinikleri
Access Rights
info:eu-repo/semantics/openAccess
Abstract
Background/aim: Extracorporeal blood purification (EBP) therapies have shown promise as potential rescue treatments for patients with septic shock. However, precise evidence regarding their effectiveness is lacking. This case-control study aimed to evaluate the 28-day survival benefit of a resin cartridge-based EBP therapy compared to conventional therapies in patients with septic shock. Materials and methods: The study sample was collected retrospectively from the medical records of patients admitted to the intensive care unit (ICU) between 2015 and 2020. The study included patients with septic shock aged ?18 years who had ICU stays >96 h and excluded those lost to follow-up by 28 days or readmitted. First, 28-day survival was compared between EBP patients and 1:1 matched conventionally treated controls. Second, the EBP patients were evaluated for clinical and laboratory improvements within 72 h of EBP therapy. Results: Of 3742 patients, 391 were included in this study, of whom 129 received EBP therapy and had a 28-day survival rate of 44%, compared to 262 matched controls who received conventional therapy alone and had a survival rate of 33% (p = 0.001, log-rank = 0.05, number needed to treat = 8, and odds ratio = 1.7). After receiving EBP therapy for 72 h, improvements were observed in the Sequential Organ Failure Assessment scores (p < 0.05), shock indices (p < 0.05), partial pressure of oxygen in the arterial blood to the fraction of inspiratory oxygen concentration ratios (p < 0.001), vasopressor requirements (p < 0.001), pH (p < 0.05), lactate levels (p < 0.001), and C-reactive protein levels (p < 0.05). Conclusion: The findings suggest that administering resin cartridge-based EBP therapy to patients with septic shock may improve their survival compared to conventional therapies. © TÜBİTAK.
Description
Keywords
Blood Purification; Critical Care; Extracorporeal Therapy; Sepsis; Septic Shock, C Reactive Protein; Dobutamine; Dopamine; Epinephrine; Hypertensive Factor; Lactic Acid; Noradrenalin; Resin; Activated Partial Thromboplastin Time; Adult; Anticoagulation; Apache; Article; Case Control Study; Continuous Renal Replacement Therapy; Controlled Study; Conventional Radiotherapy; Disease Severity; Female; Hematocrit; Hemodynamics; Horowitz Index; Human; Intensive Care; Intensive Care Unit; Laboratory Test; Length Of Stay; Major Clinical Study; Mean Arterial Pressure; Medical Record; Middle Aged; Mortality Rate; Ph; Platelet Count; Quick Sequential Organ Failure Assessment Score; Reliability; Retrospective Study; Sensitivity And Specificity; Sepsis; Septic Shock; Shock; Survival; Survival Rate; Systolic Blood Pressure; Aged; Blood; Devices; Hemofiltration; Male; Mortality; Procedures; Septic Shock; Therapy; Treatment Outcome; Adult; Aged; Case-Control Studies; Female; Hemofiltration; Humans; Intensive Care Units; Male; Middle Aged; Retrospective Studies; Shock, Septic; Survival Rate; Treatment Outcome
Journal or Series
Turkish Journal of Medical Sciences
WoS Q Value
Scopus Q Value
Q3
Volume
54
Issue
1
