Extracorporeal Blood Purification with the Oxiris Membrane in Septic Shock

Abstract

Septic shock with AKI is associated with a high mortality. We evaluated whether continuous renal replacement therapy (CRRT) using a membrane (oXiris) with adsorbing properties could improve cardio-renal response and modulate endotoxin and cytokine levels. 105 patients requiring CRRT for septic shock-AKI received CRRT with an oXiris filter. The main cardio-renal parameters, SOFA total score, SOFA organ score, endotoxin and cytokine levels were measured at baseline (T0) and 72 h after the start of CRRT (T1). Norepinephrine infusion rate, blood lactate levels, and thromboelastographic parameters were monitored. At T1, the renal function improved (p < 0.01) urinary output increased ( p < 0,.01 ) with the cardiac response and the decrease of norepinephrine infusion. SOFA total decreased to 8.4 ± 3 from 12 ± 2 (p < 0.001). Endotoxin decreased also at T 1 ( p < 0.01) with a reduction of Il 6 and procalcitonin. Lactate level ranged from 3.37 ± 3.2mto 1.67 ± 1.8 mmol/l (p < 0.01). CRRT with the oxiris filter improves the cardio renal response response in septic patients with AKI. This is associated with a modulation of endo-toxemia, of cytokines and the stability of the coagulation parameters.