Effect of the combination of HA380 hemoperfusion with CVVHDF on inflammatory indices and microcirculation in early septic shock

Abstract

Purpose: To determine the clinical efficacy of combining HA380 hemoperfusion with continuous venovenous hemodialysis filtration (CVVHDF) in early-stage septic shock.
 Methods: Data from 107 patients admitted to Affiliated Hospital of Jianghan University, China from January 2020 to January 2022 were analyzed. They were divided into control group (53 cases, on conventional treatment + CVVHDF) and study group (54 cases, on conventional treatment + CVVHDF + HA380 hemoperfusion). Changes in vital signs, renal function, inflammatory markers, microcirculatory indices and disease severity were compared before and after treatment. Adverse reactions and prognostic indicators were also recorded.
 Results: In both groups, heart rate (HR), respiratory rate, urea nitrogen (BUN), blood creatinine (Scr), calcitoninogen (PCT), c-reactive protein (CRP), interleukin (IL)-1, tumor necrosis factor (TNF)-α, Sequential Organ Failure Assessment Score (SOFA) and Acute Physiology and Chronic Health Status Scoring System II (APACHE II) decreased after 7 days of treatment. These improvements were more significant in study group relative to control group. MAP, MFI and PPV showed an elevation in study group when compared to control group. Both groups showed no marked difference in the incidence of adverse reactions (7.55 vs. 12.96 %). The study group had shorter intensive care unit (ICU) stays, duration of mechanical ventilation and total hospital stays in comparison to control group (p < 0.05).
 Conclusion: The combination of HA380 hemoperfusion and CVVHDF effectively improves renal function, controls septic shock, inhibits the inflammatory response, enhances microcirculation and improves short-term prognosis without significantly increasing adverse reactions. This treatment modality seems promising for early-stage septic shock pending outcomes of evaluating their long-term efficacy and prognosis.