Title: Renal replacement therapy with the oxiris filter in septic patients with AKI: a coohort study and a propensity – matched analysis.

Biography:

Actually Head of Intensive Care Unit of Aurelia Hospital in Rome, Italy AND Scientific Director of Intensive Care of European Hospital in Rome, Italy.

Abstract

Introduction:

Renal replacement therapy( RRT ) with the OXIRIS filter is used in sepsis septic shock with AKI , but few clinical studies compare the adsorbing effect of Oxiris filter on the inflammatory mediators to RRT.

The aim of this study is 1- to confirm whether oxiris decreases cytokines and procalcitonin in sepsis septic shock . 2- This effect is superior to RRT . 3- This translates in a better cardio renal response.

Methods:

A  coohort study and a  propensity  –  matched analysys included 73 patients admitted to three Intensive Care   ( Aurelia Hospital , European Hospital , Tor Vergata – Rome ) with a diagnosis of septic shock . 50 patients were submitted to RRT with oxiris filter and 23 patients to RRT without adsorbing filters . Il 6 , Procalcitonin EAA , the cardiorenal indices and SOFA score were compared before ( T0 ) and at the end of the treatments ( T1 ) .All data are expressed as mean ±SD. ANOVA one way was used to compare the changes of the variables in the time. P< 0,05 was considered statistically significant.

Results:

Of 50 patients submitted to RRT with the oXiris filter 32 could be matched to 22 septic patients who received RRT. IL6  Procalcitonin  and Endotoxin ( EAA) decreased in the Oxiris ( p< 0,01 ) but not in the RRT group . MAP increased ( p< 0,01 ) and noradrenaline dosage decreased in oxiris group ( p< 0,01) , but non in RRT group. Also PaO2/FIO2 ratio , diuresis , SOFA improved only in the in the oxiris group (p<0,05 ).

Conclusion:

In sepsis / septic shock patients with AKI  , CVVHDF with oXirs improves the cardio - renal function and the clinical course . The study confirms that RRT with oXiris filter may be useful in  AKI with sepsis / septic shock when other convective / diffusive techinques fail.