Survival benefit of resin cartridge extracorporeal blood purification therapy in patients with septic shock

IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Serdar Efe, P. Hancı, V. Inal
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Abstract

in Background/aim: Extracorporeal blood purification (EBP) therapies have shown promise as potential rescue treatments for patients with septic shock. However, precise evidence regarding their effectiveness is lacking. This case-control study aimed to evaluate the 28-day survival benefit of a resin cartridge-based EBP therapy compared to conventional therapies in patients with septic shock. Materials and methods: The study sample was collected retrospectively from the medical records of patients admitted to the intensive care unit (ICU) between 2015 and 2020. The study included patients with septic shock aged ≥18 years who had ICU stays >96 h and excluded those lost to follow-up by 28 days or readmitted. First, 28-day survival was compared between EBP patients and 1:1 matched conventionally treated controls. Second, the EBP patients were evaluated for clinical and laboratory improvements within 72 h of EBP therapy. Results: Of 3742 patients, 391 were included in this study, of whom 129 received EBP therapy and had a 28-day survival rate of 44%, compared to 262 matched controls who received conventional therapy alone and had a survival rate of 33% (p = 0.001, log-rank = 0.05, number needed to treat = 8, and odds ratio = 1.7). After receiving EBP therapy for 72 h, improvements were observed in the Sequential Organ Failure Assessment scores (p < 0.05), shock indices (p < 0.05), partial pressure of oxygen in the arterial blood to the fraction of inspiratory oxygen concentration ratios (p < 0.001), vasopressor requirements (p < 0.001), pH (p < 0.05), lactate levels (p < 0.001), and C-reactive protein levels (p < 0.05). Conclusion: The findings suggest that administering resin cartridge-based EBP therapy to patients with septic shock may improve their survival compared to conventional therapies.
树脂盒体外血液净化疗法对脓毒性休克患者生存的益处
背景/目的:体外血液净化(EBP)疗法有望成为脓毒性休克患者的潜在抢救疗法。然而,目前还缺乏有关其有效性的确切证据。本病例对照研究旨在评估与传统疗法相比,基于树脂盒的 EBP 疗法对脓毒性休克患者 28 天生存率的益处。材料和方法:研究样本从2015年至2020年间重症监护室(ICU)收治患者的病历中回顾性收集。研究对象包括年龄≥18岁、在重症监护室住院时间超过96小时的脓毒性休克患者,并排除了随访28天后失访或再次入院的患者。首先,比较了 EBP 患者和 1:1 匹配的常规治疗对照组的 28 天存活率。其次,评估 EBP 患者在接受 EBP 治疗 72 小时内的临床和实验室改善情况。结果:在 3742 名患者中,有 391 人被纳入本研究,其中 129 人接受了 EBP 治疗,28 天存活率为 44%,而 262 名匹配的对照组患者仅接受了常规治疗,存活率为 33%(P = 0.001,对数秩 = 0.05,治疗所需人数 = 8,几率比 = 1.7)。接受 EBP 治疗 72 小时后,下列指标均有所改善:序贯器官衰竭评估评分(p < 0.05)、休克指数(p < 0.05)、动脉血氧分压与吸入氧浓度比(p < 0.001)、血管加压剂需求(p < 0.001)、pH 值(p < 0.05)、乳酸水平(p < 0.001)和 C 反应蛋白水平(p < 0.05)。结论研究结果表明,与传统疗法相比,对脓毒性休克患者使用树脂筒式 EBP疗法可提高其存活率。
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来源期刊
Turkish Journal of Medical Sciences
Turkish Journal of Medical Sciences 医学-医学:内科
CiteScore
4.60
自引率
4.30%
发文量
143
审稿时长
3-8 weeks
期刊介绍: Turkish Journal of Medical sciences is a peer-reviewed comprehensive resource that provides critical up-to-date information on the broad spectrum of general medical sciences. The Journal intended to publish original medical scientific papers regarding the priority based on the prominence, significance, and timeliness of the findings. However since the audience of the Journal is not limited to any subspeciality in a wide variety of medical disciplines, the papers focusing on the technical  details of a given medical  subspeciality may not be evaluated for publication.
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