Continuous renal replacement therapy with the adsorbent membrane oXiris in septic patients: a clinical experience

Introduction

Renal failure is an important complication of sepsis and CRRT with adsorbing membranes may be useful in this clinical setting [1]. The aims of the study in septic/septic shock patients are to evaluate: the safety of a new hemofilter membrane oXiris with adsorbing properties and anti-endotoxin activity; the renal and hemodynamic response; and the changes of endotoxin and proinflammatory molecules.

Methods

Forty septic/septic shock patients with renal failure were enrolled in the study. All patients had preoperative endotoxin >0.6 level/units (EAA Spectral D) and were submitted to high-volume hemodiafiltration (50 ml/kg/hour, Prismaflex; Gambro) with a new treated heparin-coated membrane (oXiris; Gambro). At T0 (pre-treatment) and T1 (24 hours) the main clinical and biochemical data were evaluated. All data are expressed as mean ± SD. One-way ANOVA test with Bonferroni correction was used to evaluate the data changes. P < 0.05 was considered significant.

Results

Table 1 presents the main results of this study.

Table 1 (abstract P63)

Conclusion

In septic/septic shock patients with renal failure, CRRT with a new treated heparin-coated membrane (oXiris; Gambro) is clinically feasible, and has a positive effect on renal function and hemodynamics. An adsorbing effect on proinflammatory mediators may have a role in these results. These data and the trend toward a decrease of endotoxin during the treatment warrant further investigation.