Experience of Apheresis in the Intensive Care Unit

Abstract

Introduction: Sepsis is one of the main causes of death in critically ill patients worldwide, and in many cases it is associated with renal and/or other organ failure. However, we do not have an efficient therapy to reduce its extremely high mortality rate. In the last years the interest around the use of extracorporeal blood purification techniques has increased. One of the emerging treatments in patients with severe sepsis and septic shock is coupled plasma filtration adsorption (CPFA). CPFA is a novel extracorporeal blood purification therapy aimed at non-selectively reducing the circulating levels and activities of both pro and anti-inflammatory mediators. The aim of this study, conducted in septic patients, was to observe the effects of CPFA on mortality and several laboratory and hemodynamic parameters. Patients and Methods: We treated 65 patients (50 males and 15 females) with CPFA. We then analysed the mean arterial pressure (MAP), the sequential organ failure assessment (SOFA) score, and the acute physiology and chronic health evaluation II (APACHE II) score. Serum levels of interleukin-6 and procalcitonin were also measured. Results: After 28 days we observed a mortality of 36.9% (24 patients) and a significant reduction in IL-6, procalcitonin, SOFA and APACHE scores. Conclusion: CPFA represents a promising new approach for blood purification in sepsis.