Effect of continuous blood purification combined with reduced glutathione on endotoxin, inflammatory mediators and severity of liver injury in patients with septic shock

Abstract

Purpose: To investigate the impact of continuous blood purification in conjunction with reduced glutathione on endotoxin levels, inflammatory mediators and the severity of liver injury in septic shock patients. Methods: A cohort of 100 septic shock patients admitted at The Second Affiliated Hospital of Hainan Medical University, China between May 2020 and May 2023 were enrolled in this study. They were randomly divided into study and control groups, each comprising 50 patients. Both groups received standard interventions. In addition, control group underwent continuous blood purification, while study group received reduced glutathione therapy for two weeks. Acute physiology score + age point + chronic health point (APACHE II) and sequential organ failure assessment (SOFA) scores, intensive care unit (ICU) and mechanical ventilation duration, oxygenation levels, 28-day mortality, organ injury, serum endotoxin levels, inflammatory markers, as well as serum aspartate aminotransferase (AST) and glutamate aminotransferase (ALT) levels were determined before and after treatment. Adverse events during treatment were documented. Results: Both groups exhibited a significant decrease in APACHE II and SOFA scores, with greater decreases observed in study group (p < 0.05). The study group had shorter ICU stays and mechanical ventilation durations. The groups had no significant differences in 28-day mortality or organ injury (p > 0.05). Study group demonstrated significantly lower levels of endotoxin, tumor necrosis factor (TNF-α), procalcitoninogen (PCT), ALT and AST in comparison to control group (p < 0.05). Adverse reactions were similar between the two groups (p > 0.05). Conclusion: Combining continuous blood purification with reduced glutathione therapy reduces endotoxin and inflammatory mediator levels, mitigates liver injury and supports patient recovery in septic shock, with a favorable safety profile. Future studies to accommodate the diverse profiles of septic shock patients from multiple centers will be needed to validate the outcomes of this study.