Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2021; 9(27): 8157-8163
Published online Sep 26, 2021. doi: 10.12998/wjcc.v9.i27.8157
Successful treatment of gastrointestinal infection-induced septic shock using the oXiris® hemofilter: A case report
Yu Li, Xiao-Jun Ji, Dan-Yang Jing, Zheng-Hui Huang, Mei-Li Duan
Yu Li, Xiao-Jun Ji, Dan-Yang Jing, Zheng-Hui Huang, Mei-Li Duan, Department of Intensive Care Unit, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Author contributions: Li Y was the patient’s competent physician, reviewed the literature, and contributed to manuscript drafting; Ji XJ was the patient’s attending physician and contributed to manuscript drafting; Jing DY and Huang ZH obtained informed consent; Duan ML was responsible for the revision of the manuscript; all authors gave final approval for the submitted version.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Mei-Li Duan, MD, PhD, Chief Doctor, Professor, Department of Intensive Care Unit, Beijing Friendship Hospital Capital Medical University, No. 95 Yong'an Road, Xicheng District, Beijing 100050, China.
Received: May 1, 2021
Peer-review started: May 1, 2021
First decision: June 15, 2021
Revised: July 26, 2021
Accepted: August 16, 2021
Article in press: August 16, 2021
Published online: September 26, 2021

Septic shock leads to multiple organ failure, and bacterial endotoxins and endogenous cytokines play essential roles in the pathogenesis. The oXiris® hemofilter can efficiently adsorb endotoxins and cytokines.


We admitted a critically ill 59 year-old male patient with gastrointestinal septic shock due to infection by a Gram-negative bacterium and septic acute kidney injury (AKI). Prior to intensive care unit admission, the patient reported intermittent diarrhea and decreased urine output. His blood pressure was 70/40 mmHg, necessitating fluid resuscitation and large doses of noradrenaline. Based on the results of a blood culture and the presence of hypotension, oliguria, and hypoxemia, we diagnosed septic shock, AKI, and multiple organ dysfunction. We administered continuous renal replacement therapy (CRRT) with an oXiris® hemofilter for 72 h with intermittent continuous veno-venous hemodiafiltration (CVVHDF), and changed the filter every 12 h. After his hemodynamic parameters were stable, we used a traditional filter (AN69 hemofilter) with intermittent CVVHDF. The 72 h CRRT with the oXiris® hemofilter led to stabilization of his vital signs, marked reductions in disease severity scores, and decreased levels of procalcitonin, endotoxin, and inflammatory factors. After 8 d of CRRT, his kidney function had completely recovered.


We conclude that the oXiris® hemofilter combined with appropriate antibacterial therapy was an effective treatment for this patient with gastrointestinal septic shock.

Keywords: Sepsis, Septic shock, Acute kidney injury, Continuous renal replacement therapy, oXiris®, Case report

Core Tip: Septic shock results in multiple organ failure and is associated with a high mortality rate, and patients with septic acute kidney injury (AKI) have an even greater risk of mortality. We report the successful treatment of a patient with gastrointestinal septic AKI using continuous renal replacement therapy (CRRT) with an oXiris® hemofilter. These results suggest that early use of the oXiris® hemofilter with CCRT may be useful for other patients with gastrointestinal septic AKI.