title: Hemodialysis with High Cut-Off Hemodialyzers in Patients with Multi-Drug Resistant Gram-Negative Sepsis and Acute Kidney Injury: A Retrospective, Case-Control Study.
abstract: Hemodialysis with high cut-off continuous veno-venous hemodialyzer (HCO-CVVHD) removes mediators of organ dysfunction during sepsis. This study assessed the clinical effects of HCO-CVVHD as compared to high-flux (HF) membranes during gram-negative sepsis.
  
  
  
  Intensive care unit (ICU), septic patients treated with HCO-CVVHD or HF-CVVHDF for AKI were retrospectively observed (January 2013-December 2014). Mechanical ventilation, vasopressors' requirements, ICU length of stay (LOS) and ICU in-hospital mortality were compared between groups.
  
  
  
  Sixteen HCO and 8 HF patients were observed. Isolated pathogens included Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli and Pseudomonas aeruginosa. Median ratios of days-on-vasopressors and days-on-mechanical ventilation/ICU-LOS were 0.5, 1 and 0.8, 1 for HCO and HF groups (p < 0.03), respectively. ICU-LOS was 16 and 9 days (HCO- and HF-group, p = 0.03). ICU mortality rates were 37.5 and 87.5% for HCO and HF groups, respectively (p = 0.03). No statistical difference was found in in-hospital morality.
  
  
  
  Patients in HCO-CVVHD group spent lesser number of days on vasopressors and mechanical ventilation as a ratio to total ICU-LOS. In the same group, a reduction in ICU mortality was observed.
authors.affiliation: Department of Health Science, Section of Anesthesiology and Intensive Care, University of Florence, Florence, Italy.
authors.forename: Cosimo
authors.initials: C
authors.lastname: Chelazzi
authors.forename: Gianluca
authors.initials: G
authors.lastname: Villa
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: D'Alfonso
authors.forename: Paola
authors.initials: P
authors.lastname: Mancinelli
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Consales
authors.forename: Margherita
authors.initials: M
authors.lastname: Berardi
authors.forename: Angelo Raffaele
authors.initials: AR
authors.lastname: De Gaudio
authors.forename: Stefano
authors.initials: S
authors.lastname: Romagnoli
mesh_terms: D058186:Acute Kidney Injury; D016022:Case-Control Studies; D006801:Humans; D007362:Intensive Care Units; D007688:Kidneys, Artificial; D007902:Length of Stay; D006435:Renal Dialysis; D012189:Retrospective Studies; D018805:Sepsis