Mielnicki Wojciech, Dyla Agnieszka, Zając Marta, Rokicka-Demitraszek Natalia, Smereka Jacek
Anestesiology and Intensive Care Ward, Olawa District Hospital, 55-200 Olawa, Poland.
Department of Emergency Medical Service, Wroclaw Medical University, 51-616 Wroclaw, Poland.
J Clin Med. 2024 Dec 11;13(24):7527. doi: 10.3390/jcm13247527.
: Renal replacement therapy with an oXiris hemofilter may be helpful for patients with acute kidney injury in conjunction with sepsis and septic shock. The aim of this study was to assess the impact of an oXiris membrane on septic shock patients. : All renal replacement therapies with oXiris (Baxter, Deerfield, IL, USA) performed between January 2018 and August 2021 were retrospectively analyzed. CRRT was initiated in continuous venovenous hemodiafiltration (CVVHDF) mode using Prismaflex System (Baxter). Demographic data, starting point of infection, source control, etiology, and course of treatment were analyzed. : A total of 32 patients were included in the study. Most patients treated with oXiris had acute kidney injury (AKI) and required CRRT. One patient had KDIGO 1 AKI (3.1%), three patients (9.4%) had KDIGO 2 AKI, and 28 patients (87.5%) had KDIGO 3 AKI. A statistically significant decrease in vasopressin dosage was required to achieve adequate MAP after 24 and 72 h, and a statistically significant decrease in norepinephrine dosage after 72 h was observed, with no SOFA score change on days 2 and 3. Procalcitonin and lactate levels did not change after 24 and 72 h. No beneficial effect on mortality was observed. : Treatment with an oXiris membrane can positively impact vasopressors' requirement but not influence SOFA score, procalcitonin or lactate levels, or mortality in septic shock patients.
使用oXiris血液滤过器进行肾脏替代治疗可能有助于患有急性肾损伤合并脓毒症和感染性休克的患者。本研究的目的是评估oXiris膜对感染性休克患者的影响。：对2018年1月至2021年8月期间使用oXiris（美国伊利诺伊州迪尔菲尔德市百特公司）进行的所有肾脏替代治疗进行回顾性分析。采用Prismaflex系统（百特公司）以持续静静脉血液透析滤过（CVVHDF）模式启动连续性肾脏替代治疗（CRRT）。分析了人口统计学数据、感染起始点、源头控制、病因及治疗过程。：共有32例患者纳入本研究。大多数接受oXiris治疗的患者患有急性肾损伤（AKI）且需要CRRT。1例患者为KDIGO 1级AKI（3.1%），3例患者（9.4%）为KDIGO 2级AKI，28例患者（87.5%）为KDIGO 3级AKI。在24小时和72小时后，为达到足够的平均动脉压（MAP）所需的血管加压素剂量有统计学显著下降，且在72小时后观察到去甲肾上腺素剂量有统计学显著下降，在第2天和第3天序贯器官衰竭评估（SOFA）评分无变化。24小时和72小时后降钙素原和乳酸水平未改变。未观察到对死亡率有有益影响。：使用oXiris膜治疗可对感染性休克患者血管加压药物的需求产生积极影响，但不影响SOFA评分、降钙素原或乳酸水平，也不影响死亡率。
