Effect of a Modified AN69ST Membrane on the Clinical Course of Adult Patients with Bacterial Septic Shock

Abstract

Abstract Sepsis is among the leading causes of mortality globally. Blood purification techniques are evolving in sepsis therapy, aiming at pathogenic antigens and host cytokines. The aim of this study was to determine whether continuous renal replacement therapy (CRRT) with modified AN69ST membrane, brand name oXiris, improves the clinical course of adult patients with septic shock. The study had a retrospective, longitudinal, propensity score matching (PSM) design with two groups: treatment — CRRT started with oXiris, control — used ST150 filters only. Data from 636 patients were analysed. The oXiris and control groups included 40 and 57 patients, respectively. PSM left 19 patients in each group. Ten of 19 patients died in the oXiris group. Survival, CRRT duration, intensive care unit or hospital length of stay did not differ between the groups. The oX-iris group had a tendency for lower mortality in Gram-negative infection cases, though not statistically significant. During the first 72h of CRRT, both groups had improvement in noradrenaline requirement, arterial pressure and blood lactate. However, with oXiris treatment, increase of arterial pressure (TA) was greater during CRRT during the first 24h and there was a more significant decrease of noradrenaline infusion and lactate during the first 72 h. We concluded that in septic shock early CRRT with oXiris may be beneficial and that there might be decreased hospital mortality in the case of Gram-negative infection. Further larger studies are required.