Effect of CRRT with oXiris filter on hemodynamic instability in surgical septic shock with AKI: A pilot randomized controlled trial

Abstract

Background: Early identification and timely management of septic AKI continue to represent clinical challenges for intensive care. The aim was to evaluate the effect of renal replacement with oXiris filter on clinical outcomes in septic AKI. Methods: This was a single-center randomized controlled trial that enrolled surgical septic shock with AKI patients admitted in the ICU, Renji Hospital, Shanghai Jiao Tong University, School of Medicine from Jan 1, 2021 to Sep 30, 2021, were screened. Results: Sixteen subjects that met the inclusion and exclusion criteria were randomized into CRRT with AN69-oXiris group ( n = 8) and AN69-ST group ( n = 8). The PCT and IL-6 concentration decreased significantly after the first treatment compared to pre-CRRT levels in the oXiris group (PCT: 23.46 [4.18, 84.90] vs 52.79 [9.03, 100.00] µg/L, p = 0.046; IL-6: 3080.15 [527.62, 9806.61] vs 10,457.17 [8150.00, 15,528.87] pg/mL, p = 0.043). The levels of lactate decreased by 1.70 [1.03, 2.83] mmol/L after the first CRRT in the oXiris group ( p = 0.028). The norepinephrine infusion rate was decreased by 0.06 [0, 0.09], 0.05 [0, 0.23] and 0.11 [0, 0.23] μg/kg/min at 4, 6, and 8 h in the oXiris group compared to the ST group ( p = 0.005, 0.038, and 0.017). Conclusion: Using the oXiris filter may improve hemodynamic status during initial CRRT in severe surgical septic shock with AKI. Further large multicenter RCTs are needed to determine the effect of the oXiris filter on patient outcomes. ( http://www.chictr.org.cn/index.aspx (ChiCTR2200055732)).