Blood Purification最新文献

{"title":"Key Performance Indicators for Acute Intermittent Renal Replacement Therapy in Critically Ill Patients: A Systematic Review.","authors":"Fadi Hammal, Dawn Opgenorth, Kristin Robertson, Neesh Pannu, Scott Klarenbach, Matthew T James, Ashita Tolwani, Michael Heung, Javier A Neyra, Theresa Mottes, Edward G Clark, Janice Y Kung, Sean M Bagshaw, Oleksa Gregory Rewa","doi":"10.1159/000551175","DOIUrl":"10.1159/000551175","url":null,"abstract":"<p><strong>Introduction: </strong>Several initiatives have tried to identify key performance indicators (KPIs) for continuous renal replacement therapy. Nevertheless, no reviews of the literature for KPIs of intermittent renal replacement therapy (IRRT) have been found. This systematic review appraised the literature for KPIs of IRRT in critically ill patients.</p><p><strong>Methods: </strong>Ovid MEDLINE, Ovid Embase, CINAHL, and Cochrane Library were searched for studies investigating KPIs for IRRT. Studies were included if they contained KPIs, occurred in critically ill patients, and were associated with IRRT. Risk of bias was evaluated using the modified Cochrane tool and the Newcastle-Ottawa Quality Assessment Scale. A descriptive analysis was performed. The KPIs were evaluated for importance, scientific acceptability, usability, and feasibility.</p><p><strong>Results: </strong>Our search yielded 7,726 citations, of which 240 fulfilled eligibility criteria. This included 201 (83.8%) observational studies, 28 (11.7%) randomized controlled studies, 4 (1.7%) case series, 4 (1.7%) economic modeling studies, and 3 (1.3%) case-controlled studies. The quality of retrieved studies was variable. A total of 11 different KPIs were mentioned in 673 instances. KPIs were classified as process (n = 5, 45.5%), outcome (n = 4, 36.3%), and structure (n = 2, 18.2%). The most commonly identified KPI was mortality (n = 166) followed by solute clearance (n = 105), intradialytic hypotension (n = 104), renal recovery (n = 79), ultrafiltration achieved (n = 60), adverse events (n = 53), filter/circuit clotting (n = 49), length of stay (n = 40), hemodynamic stability (n = 39), healthcare costs (n = 14), and organization structure and leadership (n = 4). Across studies, the definitions used for KPIs evaluating similar constructs varied considerably.</p><p><strong>Conclusion: </strong>Eleven KPIs of IRRT care were identified. The heterogeneous definitions, differences in the quality of derivation, and insufficient evaluation were common characteristics. Further study is needed to define, classify, and prioritize a concise inventory of KPIs to measure, benchmark, and integrate their reporting into healthcare systems for IRRT care for critically ill patients.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"512-533"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147316415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Contributing to the Depressive Symptoms among Patients Receiving Hemodialysis: A Cross-Sectional Analysis Using the PHQ-9.","authors":"Mariana Jeremias Macedo, Bárbara Beirão, Rui Rodrigues, Luís Oliveira, Teresa Morgado","doi":"10.1159/000551823","DOIUrl":"10.1159/000551823","url":null,"abstract":"<p><strong>Introduction: </strong>Depression is the most prevalent psychiatric disorder among patients with end-stage renal disease receiving hemodialysis (HD), associated with reduced quality of life, poor treatment adherence, higher hospitalization rates, and increased mortality. This study evaluated associations between clinical and sociodemographic variables and depressive symptoms in HD patients.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in a Portuguese HD center in November 2025. Adults (≥18 years) on HD for at least 3 months were eligible. Patients with cognitive impairment, communication difficulties, advanced malignancy, and acute debilitating illness were excluded. Sociodemographic, clinical, and laboratory data were collected. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), with scores ≥10 defining clinically significant depressive symptoms. Associations were analyzed using bivariate methods and multivariate logistic regression.</p><p><strong>Results: </strong>A total of 174 patients were included (mean age 70.2 ± 13.7 years, 61.5% male). Clinically significant depressive symptoms were observed in 14 patients (8.0%). Female gender (OR = 4.71; 95% CI: 1.10-20.11; p = 0.037), higher Charlson Comorbidity Index (OR = 1.38; 95% CI: 1.04-1.83; p = 0.026), and anemia (OR = 10.54; 95% CI: 2.44-45.62; p = 0.002) were independently associated with depressive symptoms. Religious practice was inversely associated with depressive symptoms (OR = 0.08; 95% CI: 0.02-0.35; p = 0.001). No significant associations were found for other biochemical markers and sociodemographic factors.</p><p><strong>Conclusions: </strong>The prevalence of clinically significant depressive symptoms in this cohort was relatively low. Female gender, anemia, and high Charlson Comorbidity Index were independently associated with depressive symptoms, whereas engagement in religious practice was inversely associated. Systematic screening and integration of psychosocial and spiritual support into HD care may improve outcomes.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"592-598"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phoxilium® as a Phosphate-Sparing Solution for Continuous Renal Replacement Therapy in Paracetamol-Induced Acute Liver Failure.","authors":"Gabriel Chan, Caleb Fisher, Ian C Baldwin, Stephen Joseph Warrillow, Anis Chaba, Rinaldo Bellomo, Ary Serpa Neto","doi":"10.1159/000548502","DOIUrl":"10.1159/000548502","url":null,"abstract":"<p><strong>Introduction: </strong>Hypophosphataemia is common in acute liver failure (ALF) and may worsen during continuous renal replacement therapy (CRRT) with phosphate-free fluids. We aimed to evaluate the safety and efficacy of Phoxilium®, a phosphate-containing CRRT fluid.</p><p><strong>Methods: </strong>We conducted a retrospective single-center cohort study of paracetamol-induced ALF patients treated with CRRT between January 2018 and May 2024 as our ICU transitioned from Accusol® to Phoxilium®. We obtained data on demographics, biochemistry, and outcomes. We compared biochemical variables every 6 h up to 48 h post-CRRT initiation and then every 12 h until 168 h. The primary outcome was the occurrence of severe hypophosphataemia (<0.32 mmol/L).</p><p><strong>Results: </strong>In 38 ALF patients (Phoxilium® = 14 and Accusol® = 24), Phoxilium® was associated with a reduction in the incidence of severe hypophosphataemia (0% vs. 38%; p = 0.014), a reduction in its median burden (proportion of phosphate readings <0.81 mmol/L: 13% [interquartile range: 2-33%] vs. 44% [29-51%]; p = 0.001), and significantly lower phosphate supplementation requirements (median, 45 mmol [20-70 mmol] vs. 100 mmol [60-210 mmol]; p = 0.008). Phoxilium® patients experienced a small but significant decrease in median arterial pH and standard base excess, which remained within normal limits, but lower than with Accusol® (p = 0.018 and p = 0.046, respectively). No significant differences were observed in clinical outcomes.</p><p><strong>Conclusion: </strong>In paracetamol-induced ALF patients, Phoxilium® was associated with reduced incidence of severe hypophosphataemia, hypophosphataemia burden, and need of phosphate supplementation. Larger studies are needed to further assess its impact on ALF patient outcomes.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"13-25"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12795527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bovine Serum Albumin Dialysis Removes Protein-Bound Toxins from Human Serum Albumin Solution: Theory and Benchtop Validation.","authors":"Alexander Novokhodko, Nanye Du, Shaohang Hao, Ziyuan Wang, Zhiquan Shu, Martin Sadilek, Suhail Ahmad, Dayong Gao","doi":"10.1159/000550546","DOIUrl":"10.1159/000550546","url":null,"abstract":"<p><strong>Introduction: </strong>Adding a binder to dialysate improves the removal of protein-bound toxins (PBTs). Systems that use dialysate with human serum albumin (HSA) to remove PBTs show promise for improving treatment in liver failure and other fields. HSA-based systems are difficult to scale due to scarce donor blood and expensive recombinant options. We investigate bovine serum albumin (BSA) as an alternative.</p><p><strong>Methods: </strong>Computational modeling predicted the impact of dialysate-side BSA concentration on the removal of three PBTs (bilirubin, cholic acid [CA], and indoxyl sulfate [IS]). We validated our predictions using a blood analog solution with HSA and PBTs. This solution was dialyzed against dialysate with BSA at various concentrations. HSA dialysate was tested as a positive control.</p><p><strong>Results: </strong>The model accurately predicts toxin removal. For bilirubin removal, the percent error of the prediction is less than 6%. For CA and IS, the percent error is higher because final concentration values are small. However, the square root of the sum of squares error of the prediction did not exceed 0.13 mg/g and 0.25 mg/g, respectively. PBT removal by BSA matched or exceeded the results observed with HSA. The model accurately predicted the benefit of increased BSA concentration.</p><p><strong>Conclusions: </strong>This model will allow binder dialysis optimization, enabling personalized dialysis dosing for maximum PBT removal. Using BSA can overcome the scarcity of HSA, enabling large-scale treatment.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"247-254"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146096817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endotoxin: A Bona Fide Treatable Sepsis Endotype?","authors":"Hernando Gómez","doi":"10.1159/000546294","DOIUrl":"10.1159/000546294","url":null,"abstract":"<p><strong>Background: </strong>The recognition of syndromes has been a pillar of medical education and knowledge. However, treatment of syndromes is challenging because there is a disconnect between the underlying mechanisms that lead to organ injury and the clinical expression of this injury. This is an important barrier to identifying effective treatments in sepsis which may be resolved by the identification of sepsis endotypes.</p><p><strong>Summary: </strong>In this review, we discuss the rationale for considering endotoxic septic shock as a true endotype; the mechanisms by which endotoxin induce cell and organ injury and dysfunction, the strategies to recognize when it occurs and the potential treatments, focusing on endotoxin removal through extracorporeal blood purification.</p><p><strong>Key messages: </strong>There is sufficient preclinical and clinical evidence to support the notion that endotoxin is a relevant mechanism of injury in human sepsis that drives poor patient outcomes that can be identified using clinical criteria and biomarkers and that may respond to specific targeted therapies, strongly suggesting that endotoxemic septic shock is a bona fide endotype.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"422-433"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of the Selective Cytopheretic Device with Continuous Renal Replacement Therapy in Children: A Comparison of Contemporary Cohorts.","authors":"Natalja L Stanski, JangDong Seo, Todd Jenkins, Kelli A Krallman, Shina Menon, H David Humes, David J Askenazi, Rajit K Basu, Ayse Akcan-Arikan, Stuart L Goldstein, Katja M Gist","doi":"10.1159/000549111","DOIUrl":"10.1159/000549111","url":null,"abstract":"<p><p><p>Introduction: The selective cytopheretic device (SCD) is a cell-directed extracorporeal therapy approved for use in children with acute kidney injury (AKI) receiving continuous renal replacement therapy (CRRT) with sepsis/sepsis-like conditions. We compared outcomes for children treated with SCD to a contemporary cohort of children treated with CRRT alone.</p><p><strong>Methods: </strong>Secondary analysis and comparison of patients ≤22 years old and ≥10 kg from a multicenter registry of patients receiving CRRT for AKI and/or fluid overload (WE-ROCK; 2015-2021) to patients from two multicenter, prospective, interventional studies of children with AKI and multiple organ dysfunction (MODS) receiving SCD (SCD-PED-01/SCD-PED-02; 2016-2022).</p><p><strong>Results: </strong>Eighteen patients in the SCD cohort were compared to 178 in the CRRT cohort. There were no differences between cohorts at CRRT ± SCD initiation. SCD patients had shorter CRRT duration (6 [3, 11] vs. 10 [5, 18] days, p = 0.013) and shorter ICU length of stay (LOS) in survivors (16 [11, 25] vs. 27 [16, 46] days, p = 0.012). Survival to ICU discharge or day 60 was 94% in the SCD cohort vs. 74% in the CRRT cohort (p = 0.079). A Bayesian analysis demonstrated a >99% probability of improved survival with SCD. A sub-analysis in septic patients demonstrated greater survival (100% vs. 69%, p = 0.032), shorter CRRT duration (5 [3, 7] vs. 11 [6, 17] days, p = 0.006) and reduced ICU LOS in survivors (21 [10, 25] vs. 27 [16, 45] days, p = 0.027) in SCD-treated patients.</p><p><strong>Conclusions: </strong>The addition of SCD therapy in children with AKI and MODS receiving CRRT may be beneficial, though larger prospective studies are needed. </p>.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"107-113"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12668435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization and Outcomes of Septic Shock Patients with Macrophage Activation-Like Syndrome: Prognostic Role of Hyperferritinemia and Description of Hemoadsorption in Refractory Hyperinflammatory Septic Shock.","authors":"Juan Carlos Ruiz-Rodríguez, Luis Chiscano-Camón, Adolf Ruiz-Sanmartin, Carolina Maldonado, Pablo Nicolás-Morales, Clara Ramírez, Roser Ferrer-Costa, Juan José González-López, Nieves Larrosa, Ricard Ferrer","doi":"10.1159/000552315","DOIUrl":"10.1159/000552315","url":null,"abstract":"<p><strong>Introduction: </strong>Sepsis is increasingly recognized as a heterogeneous syndrome encompassing distinct immune response phenotypes. Among these, macrophage activation-like syndrome (MALS) represents a severe hyperinflammatory state characterized by dysregulated cytokine release, rapid organ failure, and extremely high mortality. Hyperferritinemia has emerged as a readily available biomarker for identifying this high-risk phenotype in septic patients. The primary objective of our study was to identify and characterize differences between septic patients fulfilling MALS criteria (ferritin >4,420 ng/mL) and those who did not, with particular focus on their clinical outcomes.</p><p><strong>Methods: </strong>A retrospective cohort study including 437 adult patients diagnosed with sepsis or septic shock according to Sepsis-3 criteria. Serum ferritin levels were measured within the first 12-24 h after sepsis onset. MALS was defined by ferritin concentrations >4,420 ng/mL. Demographic data, clinical characteristics, laboratory parameters, organ support requirements, and outcomes were compared between patients with and without MALS. In addition, outcomes of a subgroup of patients with refractory septic shock who underwent hemoadsorption therapy as rescue treatment were analyzed.</p><p><strong>Results: </strong>MALS was identified in 56 patients (12.8%). Compared with non-MALS patients, those with MALS were younger, more frequently immunosuppressed, and had higher severity scores, greater inflammatory marker levels, and more pronounced organ dysfunction. MALS patients required invasive mechanical ventilation and continuous renal replacement therapy more frequently. Intensive care unit (ICU) mortality was significantly higher in the MALS group (75% vs. 43.3%, p < 0.001), with markedly reduced 30- and 90-day survival. Hemoadsorption therapy was applied in 14 patients with extreme hyperinflammation and multiorgan failure, but ICU mortality remained high (71.4%).</p><p><strong>Conclusion: </strong>Hyperferritinemia identifies a distinct septic shock phenotype consistent with MALS, associated with catastrophic outcomes despite advanced supportive care. While ferritin measurement allows early risk stratification, current hemoadsorption strategies appear insufficient in established MALS, underscoring the urgent need for precision immunotherapy and biomarker-guided clinical trials in hyperinflammatory sepsis.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"642-649"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147959708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal Blood Purification Therapies in Latin America: Bridging Gaps in Availability and Training.","authors":"Lilia Rizo-Topete, Alejandra Molano-Triviño, Olynka Vega-Vega, Darío Jiménez, Alejandro Ferreiro, David Ballesteros, Daniela Ponce, Gonzalo Ramírez-Guerrero, Javier A Neyra, Jonathan S Chávez-Iñíguez, Rubens Lodi, Juan Castellanos-De la Hoz, Thiago Reis, Rolando Claure-Del Granado","doi":"10.1159/000550109","DOIUrl":"10.1159/000550109","url":null,"abstract":"<p><strong>Introduction: </strong>Socioeconomic and developmental diversity across Latin America (LA) significantly affects the availability of extracorporeal blood purification (EBP) therapies to treat acute kidney injury (AKI) and the training of nephrology fellows in these technologies. This survey assessed the availability of EBP therapies and perceived training needs of nephrologists and intensivists in the region.</p><p><strong>Objective: </strong>The aim of this study was to evaluate the availability of EBP therapies to treat AKI and identify training needs among LA nephrologists and intensivists.</p><p><strong>Methods: </strong>Between March and December 2024, the AKI and extracorporeal organ support therapy committee of SLANH conducted an online survey targeting nephrologists and intensivists. The survey gathered data on the availability of EBP technologies in their institutions and perceived training needs.</p><p><strong>Results: </strong>A total of 505 responses were collected, with 93% submitted by nephrologists. Participants represented 20 LA countries, primarily from South America (58%), Mexico (23.6%), and the Caribbean (10.1%). Intermittent hemodialysis (IHD) was the most widely available therapy, accessible in 98% of centers. Peritoneal dialysis (PD) was available in 65% of hospitals, while continuous renal replacement therapy (CRRT) in 59% of centers but reported as unavailable in Haiti, Nicaragua, Paraguay, and Venezuela. Therapeutic plasma exchange (TPE) was available in 60% of hospitals, although accessibility varied significantly by country. Multi-organ support therapies showed limited regional availability, including liver support (11.9%), extracorporeal membrane oxygenation (ECMO, 16.7%), extracorporeal CO₂ removal (ECCO₂R, 7%), and hemoadsorption (20.6%). The greatest perceived training needs were identified for ECMO (54.2%), ECCO₂R (51.3%), CRRT (48.7%), and TPE (46.8%), whereas demand for further training in IHD and PD was comparatively lower. These findings underscore substantial disparities in therapy access and highlight urgent regional priorities for advanced EBP training.</p><p><strong>Conclusion: </strong>This study highlights significant disparities in EBP therapy availability across LA, with advanced modalities such as CRRT and multi-organ support largely inaccessible in several countries. Additionally, there is a high perceived need for training in ECMO, ECCO₂R, CRRT, and TPE. Addressing these gaps requires expanding access to EBP, implementing standardized training programs, establishing regional centers of excellence, and fostering international collaboration. Policy advocacy and increased resource allocation will be essential to improving access and optimizing patient outcomes across the region.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"274-286"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145942526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seraph-100 Microbind Affinity Blood Filter Flow Driven by the Extracorporeal Membrane Oxygenation Circuit in Extracorporeal Membrane Oxygenation Patients.","authors":"Jason M Thomas, Nicholas E Villalobos, James K Aden, Kathryn A Negaard, Colleen Mitchell, Terence P Lonergan","doi":"10.1159/000550914","DOIUrl":"10.1159/000550914","url":null,"abstract":"<p><strong>Introduction: </strong>The Seraph-100 Microbind Affinity Blood Filter is a novel therapy for extracorporeal blood-borne pathogen removal. To guarantee adequate therapy, the Seraph-100 relies on specific blood flows over a set treatment time which is achieved by providing Seraph-100 through a dialysis machine. Septic patients on extracorporeal membrane oxygenation (ECMO) support but not on renal replacement have received Seraph-100 therapy through the ECMO circuit with the ECMO pump driving flows. However, there are limited data to prove that this strategy, which avoids the use of a dialysis machine, achieves therapeutic flow rates through the Seraph-100 filter.</p><p><strong>Methods: </strong>Our experiment involving swine models was conducted in detail with a configuration to connect the Seraph-100 circuit to the ECMO circuit and have blood flow through the filter in parallel with the patient. Seraph-100 flows were recorded at incremental changes in ECMO blood flow between 1.5 L/min and 5 L/min.</p><p><strong>Results: </strong>With flows as low as 1.5 L/min, Seraph-100 flows averaged 137.27 mL/min (95% PI: 88-223 mL/min). When ECMO flow was 5 L/min, Seraph-100 flows averaged 356.50 mL/min (95% PI: 272-536 mL/min). Adding the Seraph-100 circuit caused ECMO revolutions per minute (RPMs) to increase by 31.2 (p < 0.05) and venous pressures to drop by -3.47 mm Hg (p < 0.05) to maintain the same ECMO blood flow.</p><p><strong>Conclusion: </strong>Connecting a Seraph-100 filter directly to an ECMO circuit and having Seraph-100 blood flow driven by the ECMO pump is feasible. This configuration achieves adequate flows for clinical therapy and has minimal changes in ECMO dynamics.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"268-273"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146148884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interleukin-6 Removal and Clinical Effects of Oxiris: A Systematic Review and Meta-Analysis.","authors":"Arnau Ulsamer, Diego Pomarè Montin, Vittorio Bocciero, Tania Julieth Parra Morales, Lorenzo Tofani, Luca di Girolamo, Stefano Romagnoli, Gianluca Villa, Matteo Cecchi","doi":"10.1159/000547587","DOIUrl":"10.1159/000547587","url":null,"abstract":"<p><strong>Introduction: </strong>Sepsis is a life-threatening condition associated with high mortality due to an unregulated host immune response. Extracorporeal blood purification (EBP) therapies have been proposed as adjunctive treatments to immunomodulate patients; however, none have been consistently shown to be effective in reducing mortality. In several observational studies, Oxiris has been associated with cytokine reduction and a potential benefit in influencing inflammatory diseases. This meta-analysis explores the association between cytokine removal and clinical efficacy of the Oxiris membrane using interleukin-6 (IL-6) as a biomarker.</p><p><strong>Methods: </strong>This review includes articles on EBP with Oxiris membranes in adult patients with sepsis/septic shock or COVID-19. No time or language restrictions were applied to the systematic literature search. Data extraction and statistical analysis were limited to the cytokines and clinical data reported in the included articles. The most representative cytokine was IL-6 and the selected outcomes included Vasoactive-Inotropic Score (VIS), SOFA score, procalcitonin (PCT) and C-reactive protein (CRP). The review used meta-analysis and unpaired t test to estimate differences between groups of patients treated with or without Oxiris.</p><p><strong>Results: </strong>The study found no significant differences in demographics between the intervention and control groups at baseline. Intervention group showed a significant reduction in vasoactive inotropic score, norepinephrine dose, SOFA score, PCT, and CRP.</p><p><strong>Conclusion: </strong>We reviewed 8 studies in which IL-6 was significantly reduced in the Oxiris group compared to the control. This meta-analysis found that the use of the Oxiris membrane resulted in significant clinical improvement during treatment.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"454-463"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144727744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}