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Journal Articles Blood Purification Year : 2019

Sepsis Management with a Blood Purification Membrane: European Experience

Peter Pickkers
  • Function : Author
Timon Vassiliou
  • Function : Author
Valdis Liguts
  • Function : Author
Federico Prato
  • Function : Author
Stephan Kloesel
  • Function : Author
Franco Turani
  • Function : Author
Dijana Popevski
  • Function : Author
Marcus Broman
  • Function : Author
Ciprian Mihai Gindac
  • Function : Author
Faouzi Saliba
  • Function : Author
Marco Tengattini
  • Function : Author
Jacques Goldstein
  • Function : Author
Kai Harenski
  • Function : Author

Abstract

BACKGROUND: Septic shock is a leading cause of acute kidney injury (AKI). Endotoxins and cytokine levels are associated with the occurrence and severity of AKI, and different blood purification devices are available to remove them from circulation. One such device, oXiris, is a hollow-fibre purification filter that clears both endotoxins and cytokines. Due to limited evidence, clinical use of this device is not currently advocated in guidelines. However, clinics do regularly use this device, and there is a critical need for guidance on the application of it in sepsis with and without AKI. METHOD: A modified Delphi-based method was used to collate -European experts' views on the indication(s), initiation and discontinuation criteria and success measures for oXiris. RESULTS: A panel of 14 participants was selected based on known clinical expertise in the areas of critical care and sepsis management, as well as their experience of using the oXiris blood purification device. The participants used different criteria to initiate treatment with oXiris in sepsis patients with and without AKI. Septic shock with AKI was the priority patient population, with oXiris used to rapidly improve haemodynamic parameters. Achieving haemodynamic stability within 72 h was a key factor for determining treatment success. CONCLUSION: In the absence of established guidelines, users of hollow-fibre purification devices such as oXiris may benefit from standardised approaches to selecting patients and initiating and terminating treatment, as well as measuring success. Further evidence in the form of randomised clinical trials is urgently required.

Dates and versions

hal-02531021 , version 1 (03-04-2020)

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Peter Pickkers, Timon Vassiliou, Valdis Liguts, Federico Prato, Pierre Tissieres, et al.. Sepsis Management with a Blood Purification Membrane: European Experience. Blood Purification, 2019, 47 Suppl 3, pp.1--9. ⟨10.1159/000499355⟩. ⟨hal-02531021⟩
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