Extracorporeal Blood Purification with the oXiris® Filter for Patients with Sepsis and Hyperinflammatory Conditions: The Asia-Pacific oXiris Expert Meeting 2024 Consensus Statements.

Abstract

Extracorporeal blood purification (EBP) is an emerging technique for reducing elevated levels of inflammatory mediators and/or endotoxins in critically ill patients with sepsis or other hyperinflammatory conditions. The oXiris filter combines endotoxin adsorption, cytokine adsorption, hemofiltration and anti-thrombosis, and an emerging body of evidence demonstrates its use in critical care patients with hyperinflammatory conditions and acute kidney injury (AKI). A group of Asia-Pacific experts convened to formulate consensus statements for the use of the oXiris filter based on a comprehensive review of publications. After evaluation using a Delphi methodology, 17 statements achieved consensus (three recommendations and 14 practice points). These offer guidance on the initiation, monitoring and evaluation of treatment with the oXiris filter in patients with sepsis, septic shock, severe COVID-19 or other hyperinflammatory states. We also recommend using the oXiris filter in patients undergoing cardiopulmonary bypass for cardiac surgery who are at risk for developing AKI. Other statements discuss modality, dosage, filter lifespan, anticoagulation and combining the oXiris filter set with other extracorporeal therapies. Taken together, our statements offer targeted guidance for clinicians on the use of the oXiris filter across different patient populations. Additionally, we highlight the limitations of the current evidence base and identify key areas requiring further research.