Published online Sep 16, 2023. doi: 10.12998/wjcc.v11.i26.6073
Peer-review started: April 21, 2023
First decision: June 14, 2023
Revised: July 4, 2023
Accepted: July 14, 2023
Article in press: July 14, 2023
Published online: September 16, 2023
Processing time: 139 Days and 23.9 Hours
The mortality rate from septic shock in patients with hematological malignancies (HMs) remains significantly higher than that in patients without HMs.
Continuous renal replacement therapy (CRRT) with oXiris® might shorten the time from resuscitation to fluid negative balance. It may also improve hemodynamic parameters and decrease the blood levels of inflammatory mediators.
This study aimed to explore the effects of CRRT and oXiris® in shortening the resuscitation time as well as a modifier for the host response by reducing levels of inflammation mediators.
Patients with HMs who were diagnosed with septic shock and underwent CRRT were divided into two groups based on the hemofilter used. The days with negative balance and total fluid balance after 7 d of CRRT were compared between the groups. The heart rate, norepinephrine dose, Sequential Organ Failure Assessment (SOFA) score, and blood lactic acid levels at different time points in the two groups were also compared.
The average total fluid balance after 7 d of CRRT in the oXiris® group was significantly lower than that of patients in the M150 hemofilter group, and the SOFA scores of patients after CRRT with oXiris® therapy were significantly lower than those before treatment on day 1 (d1), d3 and d7 after CRRT; these parameters were also significantly lower than those of the control group on d7. Lactate levels after CRRT with oXiris® therapy were significantly lower than those before treatment on d3 and d7 after CRRT. In the oXiris® group, procalcitonin levels decreased on d7, and interleukin-6 and tumor necrosis factor- levels reduced significantly on both d3 and d7 after oXiris® treatment.
CRRT with oXiris® hemofilter might improve the hemodynamic parameters and play a role in shortening the resuscitation period, thus decreasing the total fluid balance in the resuscitation phase.
CRRT with an oXiris® hemofilter may be used as a host response modulation method in patients with septic shock and HM. This may improve hemodynamic parameters by reducing the levels of inflammatory mediators.