Coupled plasma fi ltration and adsorption in septic shock: a multicentric experience

Introduction Recently extracorporeal removal of mediators and endotoxins improved haemodynamics, organ dysfunction and mortality in patients with abdominal sepsis. Coupled plasma fi ltration and adsorption (CPFA), too, may improve haemodynamics, respiratory function and mortality through removal of proinfl ammatory mediator. The aim of this multicentric study is to evaluate the haemodynamic response and the respiratory function, and to evaluate the reduction of infl ammatory markers during CPFA. Methods Fiftyfive septic patients were enrolled in this study. Every patient had four CPFA treatments (LINDA; Bellco-Mirandola, Italy) for 8 hours with Qb = 200 ml/minute, Q ultrafi ltration = 30 ml/kg/hour and Q plasma = 20% of Qb. At T0 (basal), T1 (after fi rst cycle), T2 (after second cycle), T3 (after third cycle)and T4 (after fourth cycle) we evaluated haemodynamic parameters,norepinephrine dosage, PaO2/FiO2 ratio, plasma IL-6, and procalcitonin(PCT). The ANOVA test was used to compare changes during times study. P <0.05 was considered statistically signifi cant. Results Patients enrolled in the study have been submitted to 256 CPFA treatments for 2,650 hours. Table 1 presents the main results of the study. IV quartile of IL-6 is shown in Table 1.