The Clinical and Laboratory Efficacy of HA 330 Treatment Combined with Continuous Renal Replacement Therapy in Septic Shock Patients: A Case Series

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Article / Publication Details

First-Page Preview

Abstract of Critical Care Nephrology – Research Article

Received: August 18, 2022
Accepted: November 03, 2022
Published online: January 12, 2023

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 4

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU

Abstract

Introduction: Blood purification therapy is a method used to enable cytokine removal and to improve disturbed immune homeostasis in patients with sepsis or septic shock. This study aimed to evaluate the impact of HA 330 treatment on biochemical and hemodynamic parameters and cytokine levels in adult patients with septic shock. Methods: Critically ill patients with septic shock who received continuous veno-venous hemodiafiltration and HA 330 treatment were included in this prospective observational study. Biochemical and hemodynamic parameters were followed throughout HA 330 treatment. Serum interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor (TNF)-α, high-mobility group box1 (HMGB-1) protein, IL-10 levels were analyzed by ELISA method, before and after each HA 330 session. Results: A total of 18 critically ill patients were included in this study. The median APACHE 2 score was 22.2 ± 7.49 and median SOFA score 9.6 ± 5.44 on intensive care unit admission. SOFA scores were significantly decreased on the 3rd day of HA 330 treatment, compared to 2nd day scores (p = 0.017). Median leukocyte value was significantly decreased (p = 0.027 and p = 0.024), while hemodynamic parameters remained unchanged throughout the HA 330 treatment. Median CRP and procalcitonin levels were significantly reduced at day 3 of HA 330 treatment compared to the baseline (p = 0.015 and p = 0.033, respectively). Serum IL-1 β, IL-6, IL-8, TNF-a, HMGB-1, and IL-10 levels decreased insignificantly by 11.5%, 26.4%, 11.4%, 37.9%, 0.02%, and 35.5%, respectively, at the end of the hemoperfusion treatment compared to the pre-treatment. Conclusion: The administration of HA 330-based hemoperfusion in septic shock patients revealed improvements in SOFA scores, leukocyte count, and CRP and procalcitonin levels. However, there was no statistically significant change in concentrations of inflammatory cytokines and hemodynamic parameters during HA 330 treatment.

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References Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):801–10. Shankar-Hari M, Harrison DA, Rubenfeld GD, Rowan K. Epidemiology of sepsis and septic shock in critical care units: comparison between sepsis-2 and sepsis-3 populations using a national critical care database. Br J Anaesth. 2017;119(4):626–36. Hellman T, Uusalo P, Järvisalo MJ. Renal replacement techniques in septic shock. Int J Mol Sci. 2021;22(19):10238. Sipahioğlu H, Onuk S, Dirik H, Bulut K, Sungur M, Gündoğan K. Evaluation of non-intensive care unit-acquired sepsis and septic shock patients in intensive care unit outcomes. Erciyes Med J. 2022;44(2):161–6. Kellum JA, Kong L, Fink MP, Weissfeld LA, Yealy DM, Pinsky MR, et al. Understanding the inflammatory cytokine response in pneumonia and sepsis: results of the genetic and inflammatory markers of sepsis (GenIMS) study. Arch Intern Med. 2007;167(15):1655–63. David S, Thamm K, Schmidt BMW, Falk CS, Kielstein JT. Effect of extracorporeal cytokine removal on vascular barrier function in a septic shock patient. J Intensive Care. 2017;5:12. Zhang L, Feng Y, Fu P. Blood purification for sepsis: an overview. Precis Clin Med. 2021;4(1):45–55. Ankawi G, Fan W, Pomarè Montin D, Lorenzin A, Neri M, Caprara C, et al. A new series of sorbent devices for Multiple clinical purposes: current evidence and future directions. Blood Purif. 2019;47(1–3):94–100. Huang Z, Wang SR, Su W, Liu JY. Removal of humoral mediators and the effect on the survival of septic patients by hemoperfusion with neutral microporous resin column. Ther Apher Dial. 2010;14(6):596–602. Clark WR, Ferrari F, La Manna G, Ronco C. Extracorporeal sorbent technologies: basic concepts and clinical application. Contrib Nephrol. 2017;190:43–57. Neri M, Villa G, Garzotto F, Bagshaw S, Bellomo R, Cerda J, et al. Nomenclature for renal replacement therapy in acute kidney injury: basic principles. Crit Care. 2016;20(1):318. Villa G, Neri M, Bellomo R, Cerda J, De Gaudio AR, De Rosa S, et al. Nomenclature for renal replacement therapy and blood purification techniques in critically ill patients: practical applications. Crit Care. 2016;20(1):283. Huang Z, Wang SR, Yang ZL, Liu JY. Effect on extrapulmonary sepsis-induced acute lung injury by hemoperfusion with neutral microporous resin column. Ther Apher Dial. 2013;17(4):454–61. Lelubre C, Vincent JL. Mechanisms and treatment of organ failure in sepsis. Nat Rev Nephrol. 2018;14(7):417–27. Supady A, Brodie D, Wengenmayer T. Extracorporeal haemoadsorption: does the evidence support its routine use in critical care? Lancet Respir Med. 2022;10(3):307–12. Kaçar CK, Uzundere O, Kandemir D, Yektaş A. Efficacy of HA330 hemoperfusion adsorbent in patients followed in the intensive care unit for septic shock and acute kidney injury and treated with continuous venovenous hemodiafiltration as renal replacement therapy. Blood Purif. 2020;49(4):448–56. Koc S, Celebi S, Hanikoglu F, Polat Y, Borku Uysal B, Dokur M, et al. Can the reduction of cytokines stop the progression of sepsis? Cureus. 2022;14(2):e22325. Malard B, Lambert C, Kellum JA. In vitro comparison of the adsorption of inflammatory mediators by blood purification devices. Intensive Care Med Exp. 2018;6(1):12. Gruda MC, Ruggeberg KG, O’Sullivan P, Guliashvili T, Scheirer AR, Golobish TD, et al. Broad adsorption of sepsis-related PAMP and DAMP molecules, mycotoxins, and cytokines from whole blood using CytoSorb® sorbent porous polymer beads. PLoS One. 2018;13(1):e0191676. Poli EC, Rimmelé T, Schneider AG. Hemoadsorption with CytoSorb ®. Intensive Care Med 2019;45(2):236–9. Pomarè Montin D, Ankawi G, Lorenzin A, Neri M, Caprara C, Ronco C. Biocompatibility and cytotoxic evaluation of new sorbent cartridges for blood hemoperfusion. Blood Purif. 2018;46(3):187–95. Popescu M, Dima S, David C, Tudor A, Simionescu M, Tomescu D. Standard renal replacement therapy combined with hemoadsorption in the treatment of critically ill septic patients. Ther Apher Dial. 2021;25(5):663–70. Wendel Garcia PD, Hilty MP, Held U, Kleinert EM, Maggiorini M. Cytokine adsorption in severe, refractory septic shock. Intensive Care Med. 2021;47(11):1334–6. Zuccari S, Damiani E, Domizi R, Scorcella C, D’Arezzo M, Carsetti A, et al. Changes in cytokines, haemodynamics and microcirculation in patients with sepsis/septic shock undergoing continuous renal replacement therapy and blood purification with CytoSorb. Blood Purif. 2020;49(1–2):107–13. Article / Publication Details

First-Page Preview

Abstract of Critical Care Nephrology – Research Article

Received: August 18, 2022
Accepted: November 03, 2022
Published online: January 12, 2023

Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 4

ISSN: 0253-5068 (Print)
eISSN: 1421-9735 (Online)

For additional information: https://www.karger.com/BPU

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