Effects of the volume of processed plasma on the outcome, arterial pressure and blood procalcitonin levels in patients with severe sepsis and septic shock treated with coupled plasma filtration and adsorption.
OBJECTIVE
To understand how coupled plasma filtration and adsorption (CPFA) could influence the time course of the advanced stages of sepsis, mean arterial pressure (MAP) and norepinephrine dosage.


METHODS
Patients with severe sepsis and septic shock with ≥2 organ failures not responding to volume resuscitation and vasopressor infusion were treated with CPFA within 8 h of admission to the intensive care unit.


RESULTS
Thirty-nine patients were treated (median age: 63 years, median SAPS II score: 45) and 28 survived advanced sepsis. In the latter, the median MAP increased and the norepinephrine dosage decreased significantly after CPFA, whereas in the nonsurvivors these values did not change significantly. The volume of treated plasma was significantly higher in survivors than nonsurvivors.


CONCLUSIONS
These results suggest a possible existence of a dose-response effect for CPFA. Future studies are therefore recommended to evaluate the efficacy of this treatment and to determine its best timing and intensity.
Department of Anaesthesia and Intensive Care Medicine, University of Trieste, Trieste, Italy.
Giorgio
G
Berlot
Antoinette
A
Agbedjro
Ariella
A
Tomasini
Francesco
F
Bianco
Ugo
U
Gerini
Marino
M
Viviani
Fabiola
F
Giudici
D000368:Aged; D062186:Arterial Pressure; D002116:Calcitonin / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006439:Hemodynamics; D006440:Hemofiltration / Q000379:methods / Q000592:standards; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011498:Protein Precursors / Q000097:blood; D018805:Sepsis / Q000097:blood / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy*; D012772:Shock, Septic / Q000097:blood / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome
C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide