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oXiris® Use in Septic Shock: Experience of Two French Centres.
Schwindenhammer, Victor; Girardot, Thibaut; Chaulier, Kevin; Grégoire, Arnaud; Monard, Céline; Huriaux, Laetitia; Illinger, Julien; Leray, Véronique; Uberti, Thomas; Crozon-Clauzel, Jullien; Rimmelé, Thomas.
Afiliación
  • Schwindenhammer V; Anaesthesia and Critical Care Medicine Department, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.
  • Girardot T; Anaesthesia and Critical Care Medicine Department, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France, thibaut.girardot@chu-lyon.fr.
  • Chaulier K; EA 7426 PI3 (Pathophysiology of Injury-Induced Immunosuppression), Claude Bernard University Lyon 1-bioMérieux-Hospices Civils de Lyon, Lyon, France, thibaut.girardot@chu-lyon.fr.
  • Grégoire A; Intensive Care Unit, L'Hôpital Nord-Ouest, Villefranche-sur-Saône General Hospital, Gleizé, France.
  • Monard C; Anaesthesia and Critical Care Medicine Department, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.
  • Huriaux L; Anaesthesia and Critical Care Medicine Department, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.
  • Illinger J; Anaesthesia and Critical Care Medicine Department, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.
  • Leray V; Intensive Care Unit, L'Hôpital Nord-Ouest, Villefranche-sur-Saône General Hospital, Gleizé, France.
  • Uberti T; Anaesthesia and Critical Care Medicine Department, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.
  • Crozon-Clauzel J; Anaesthesia and Critical Care Medicine Department, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.
  • Rimmelé T; Anaesthesia and Critical Care Medicine Department, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.
Blood Purif ; 47 Suppl 3: 1-7, 2019.
Article en En | MEDLINE | ID: mdl-30982028
BACKGROUND: Sepsis is a dysregulated host response to an infection and can result in organ dysfunctions and death. Extracorporeal blood purification techniques aim to improve the prognosis of these patients by modulating the unbalanced immune response. This study reports our experience with the use of the oXiris® membrane for septic shock patients requiring continuous renal replacement therapy (CRRT). SUMMARY: Thirty-one patients were diagnosed with septic shock and underwent CRRT with the oXiris® membrane between 2014 and 2019. We compared the observed hospital mortality with that predicted by the Simplified Acute Physiology Score II (SAPS II). Change in the Sequential Organ Failure Assessment (SOFA) score and of the main clinical and biological parameters over time were analyzed. Hospital mortality was lower than predicted for the most severe patients (60 vs. 91% for the [74-87] SAPS II quartile and 70 vs. 98% for the [87-163] SAPS II quartile, p < 0.02). There was no significant improvement in the SOFA score from 0h to 48 h. An 88% relative decrease in norepinephrine infusion was observed (median at 0 h was 1.69 [0.52-2.45] µg/kg/min; at 48 h it was 0.20 [0.09-1.14] µg/kg/min, p = 0.002). Lactataemia and pH were significantly improved over time. Patients with intra-abdominal sepsis as well as those with Gram-negative bacilli (GNB) infections seemed to benefit the most from the therapy. Key Messages: CRRT with the oXiris® haemofilter resulted in higher observed survival than predicted by a severity score (SAPS II) for the most severe patients. Haemodynamic status and lactataemia appeared to improve, especially in intra-abdominal sepsis and GNB infections.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Choque Séptico / Hemofiltración / Mortalidad Hospitalaria / Infecciones por Bacterias Gramnegativas / Insuficiencia Multiorgánica Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Blood Purif Año: 2019 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Choque Séptico / Hemofiltración / Mortalidad Hospitalaria / Infecciones por Bacterias Gramnegativas / Insuficiencia Multiorgánica Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Blood Purif Año: 2019 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Suiza