Nattapat Wongtirawit, Phitphiboon Deawtrakulchai, Anupol Panitchote, R. Ratanarat
{"title":"细胞因子吸附剂血液灌注治疗去甲肾上腺素耐药脓毒性休克的临床疗效:清洁随机临床试验方案","authors":"Nattapat Wongtirawit, Phitphiboon Deawtrakulchai, Anupol Panitchote, R. Ratanarat","doi":"10.54205/ccc.v30.255033","DOIUrl":null,"url":null,"abstract":"Background: Due to the pivotal role of inflammatory cytokines in sepsis, hemoperfusion with cytokine adsorbents may lead to better outcomes. Although previous studies showed inconclusive results, proper patient selection and timing of hemoperfusion may lead to improved survival.\n\nObjectives: To examine whether patients with septic shock requiring high-dose vasopressors undergoing add-on hemoperfusion with a cytokine adsorbent have better clinical outcomes than those treated with standard treatment alone.\n\nMethods: This is a multi-center, randomized controlled study in 2 tertiary care centers. 206 patients with septic shock receiving norepinephrine of 0.2 mcg/kg/min or higher are randomized to receive either standard treatment combined with 3-hour sessions of hemoperfusion with cytokine adsorbent for two consecutive days (HP group) or standard treatment alone (ST group). The primary outcome is 28-day mortality. Secondary outcomes include hospital and ICU mortality, shock reversal, vasoactive-inotropic score (VIS), organ support-free days, interleukin-6 levels, as well as safety data.\n\nConclusions: This study will provide information to guide the use of hemoperfusion with a cytokine adsorbent in patients with septic shock.","PeriodicalId":76963,"journal":{"name":"AACN clinical issues in critical care nursing","volume":"46 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical efficacy of hemoperfusion with a cytokine adsorbent in norepinephrine-resistant septic shock: protocol for the CLEANSE randomized clinical trial\",\"authors\":\"Nattapat Wongtirawit, Phitphiboon Deawtrakulchai, Anupol Panitchote, R. Ratanarat\",\"doi\":\"10.54205/ccc.v30.255033\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Due to the pivotal role of inflammatory cytokines in sepsis, hemoperfusion with cytokine adsorbents may lead to better outcomes. Although previous studies showed inconclusive results, proper patient selection and timing of hemoperfusion may lead to improved survival.\\n\\nObjectives: To examine whether patients with septic shock requiring high-dose vasopressors undergoing add-on hemoperfusion with a cytokine adsorbent have better clinical outcomes than those treated with standard treatment alone.\\n\\nMethods: This is a multi-center, randomized controlled study in 2 tertiary care centers. 206 patients with septic shock receiving norepinephrine of 0.2 mcg/kg/min or higher are randomized to receive either standard treatment combined with 3-hour sessions of hemoperfusion with cytokine adsorbent for two consecutive days (HP group) or standard treatment alone (ST group). The primary outcome is 28-day mortality. Secondary outcomes include hospital and ICU mortality, shock reversal, vasoactive-inotropic score (VIS), organ support-free days, interleukin-6 levels, as well as safety data.\\n\\nConclusions: This study will provide information to guide the use of hemoperfusion with a cytokine adsorbent in patients with septic shock.\",\"PeriodicalId\":76963,\"journal\":{\"name\":\"AACN clinical issues in critical care nursing\",\"volume\":\"46 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-08-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"AACN clinical issues in critical care nursing\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.54205/ccc.v30.255033\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"AACN clinical issues in critical care nursing","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.54205/ccc.v30.255033","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Clinical efficacy of hemoperfusion with a cytokine adsorbent in norepinephrine-resistant septic shock: protocol for the CLEANSE randomized clinical trial
Background: Due to the pivotal role of inflammatory cytokines in sepsis, hemoperfusion with cytokine adsorbents may lead to better outcomes. Although previous studies showed inconclusive results, proper patient selection and timing of hemoperfusion may lead to improved survival.
Objectives: To examine whether patients with septic shock requiring high-dose vasopressors undergoing add-on hemoperfusion with a cytokine adsorbent have better clinical outcomes than those treated with standard treatment alone.
Methods: This is a multi-center, randomized controlled study in 2 tertiary care centers. 206 patients with septic shock receiving norepinephrine of 0.2 mcg/kg/min or higher are randomized to receive either standard treatment combined with 3-hour sessions of hemoperfusion with cytokine adsorbent for two consecutive days (HP group) or standard treatment alone (ST group). The primary outcome is 28-day mortality. Secondary outcomes include hospital and ICU mortality, shock reversal, vasoactive-inotropic score (VIS), organ support-free days, interleukin-6 levels, as well as safety data.
Conclusions: This study will provide information to guide the use of hemoperfusion with a cytokine adsorbent in patients with septic shock.