48451
document
Removal of humoral mediators and the effect on the survival of septic patients by hemoperfusion with neutral microporous resin column . The aim of this study is to evaluate the impact of neutral microporous resin hemoperfusion on hemodynamic improvement , removal of inflammatory cytokines , and mortality in critical care patients with severe sepsis . Forty-four patients with severe sepsis or septic shock were randomized to HA type hemoperfusion treatment ( N=24 ) or standard therapy ( N=20 ) . Those undergoing hemoperfusion treatment received HA330 hemoperfusion . We measured the plasma concentrations of IL-6 and IL-8 at the start of every hemoperfusion treatment , and the following parameters were compared between the control group and the hemoperfusion group on days 3 , 7 , and 14 : hemodynamics ( cardiac index , systemic vascular resistance index , heart rate , and mean arterial pressure ) ; change of hematology and coagulation function ; organ function ; and the sequential organ failure assessment ( SOFA ) score . Hospital , 28-day , and ICU mortality were also observed . Patients treated with HA hemoperfusion showed a significant removal of plasma IL-6 and IL-8 over time while in the study . Patients in the HA group also demonstrated significant increases in cardiac index , systemic vascular resistant index , fast withdrawal of vasoactive agents and decreases in heart rate compared with the controls at days 3 and 7 . Although there was no significant difference between the groups in organ dysfunction as assessed by SOFA scores from day 0 ( baseline ) to day 7 , significant improvement can be demonstrated in the hemoperfusion group at day 14 . There was no significant difference between the groups in 28-day mortality , hospital mortality , or length of hospital stay , but ICU mortality and the length of ICU stay in the HA group were markedly reduced . Hemoperfusion treatment using the HA type cartridge in sepsis is safe and it may improve organ dysfunction , ICU mortality , and shorten the length of ICU stay . Clinical significant removal of inflammatory cytokines such as IL-6 and IL-8 from circulation by hemoperfusion may contribute to improving a patient 's outcome in an ICU .
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Intervention_Pharmacological
hemoperfusion
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Intervention_Pharmacological
neutral microporous resin hemoperfusion
48454
Intervention_Pharmacological
HA type hemoperfusion treatment
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Intervention_Pharmacological
HA330 hemoperfusion
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Intervention_Pharmacological
hemoperfusion
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Intervention_Pharmacological
HA hemoperfusion
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Intervention_Pharmacological
hemoperfusion
48459
Outcome_Physical
plasma concentrations of IL-6
48460
Outcome_Physical
IL-8
48461
Outcome_Physical
hemodynamics ( cardiac index , systemic vascular resistance index , heart rate , and mean arterial pressure
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Outcome_Physical
change of hematology and coagulation function
48463
Outcome_Physical
organ function
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Outcome_Physical
sequential organ failure assessment ( SOFA ) score
48465
Outcome_Mortality
Hospital , 28-day , and ICU mortality
48466
Outcome_Physical
plasma IL-6
48467
Outcome_Physical
IL-8
48468
Outcome_Other
significant increases
48469
Outcome_Physical
cardiac index , systemic vascular resistant index
48470
Outcome_Physical
fast withdrawal of vasoactive agents and decreases in heart rate
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Outcome_Other
significant difference
48472
Outcome_Physical
organ dysfunction
48473
Outcome_Physical
SOFA scores
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Outcome_Other
significant difference
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Outcome_Mortality
28-day mortality , hospital mortality , or length of hospital stay , but ICU mortality and the length of ICU stay
48476
Outcome_Other
reduced .
48477
Outcome_Other
organ dysfunction , ICU mortality , and shorten the length of ICU stay .
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Outcome_Physical
IL-6
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Outcome_Physical
IL-8
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Participant_Condition
septic
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Participant_Condition
severe sepsis .
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Participant_Sample-size
Forty-four
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Participant_Condition
severe sepsis or septic shock