P1095USE OF CYTOKINE ADSORBING MEMBRANES IN PATIENTS WITH ACUTE RENAL FAILURE IN INTENSIVE CARE UNITS

Abstract

Abstract Background and Aims Use of cytokine adsorbents has been proposed as a novel therapeutic approach in sepsis management. Our aim was to evaluate laboratory markers, clinical parameters and SOFA (Sequential Organ Failure Assessment) score in patients who were treated with cytokine adsorbing membrane (CytoSorb®, CytoSorbents Corp. New Jersey, USA) and continuous veno-venous haemodialysis. Method We included adult patients with septic shock and acute renal failure. We retrospectively collected laboratory results (leukocytes, thrombocytes, C-reactive protein, procalcitonin, lactate, urea, creatinine, bilirubin, PaO2), clinical parameters (mean arterial pressure (MAP), FiO2, residual diuresis), SOFA score and vasopressor use at the beginning and at the end of the procedure. Results We included 69 patients, 51 men, aged 56.6 ± 15 years. 51 patients had 1 procedure, 14 patients had 2 procedures, 3 patients had 3 procedures and 1 patient had 4 procedures. Median time from admission to initiation of procedure was 47 hours, median treatment time was 23.6 hours. We discovered significant improvement in procalcitonin (35.36 ± 37.33 ng/mL vs. 24.25 ± 31.18 ng/mL; p<0.001), creatinine (345.06 ± 174.65 μmol/L vs. 233.11 ± 108.82 μmol/L; p<0.0001), SOFA score (14.20 ± 2.64 vs. 12.69 ± 3.52; p<0.001) and FiO2 (48.17 ± 21.17 % vs. 44.63 ± 21.45 %; p=0.020). Patients with more than 1 procedure showed statistically significant reduction in lactate level (5.40 ± 4.74 mmol/L vs. 2.46 ± 1.74 mmol/L; p=0.010) and vasopressin dose (1.26 ± 1.61 vs. 0.88 ± 3.2 IU/h; p=0.022). Conclusion We observed potential beneficial effect of adsorptive membrane use in septic patients. According to our results two or more procedures were associated with improved laboratory markers and lower vasopressor requirement.