Title |
Hemodynamic response to coupled plasmafiltration-adsorption in human septic shock
|
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Published in |
Intensive Care Medicine, March 2003
|
DOI | 10.1007/s00134-003-1724-0 |
Pubmed ID | |
Authors |
Marco Formica, Carlo Olivieri, Sergio Livigni, Giulio Cesano, Antonella Vallero, Mariella Maio, Ciro Tetta |
Abstract |
The objective was to examine the effect of repeated applications of coupled plasmafiltration-adsorption on the hemodynamic response in septic shock patients hospitalized in intensive care units (ICUs). Prospective, intention-to-treat. General ICU of a tertiary care, non-teaching, 400-bed, city hospital. Twelve consecutive mechanically ventilated septic shock patients, with or without concomitant acute renal failure (ARF). A median of 10 consecutive sessions (prescribed treatment time: 10 h/session; delivered duration: 8.43+/-1.37 h/min) of coupled plasmafiltration-adsorption for each patient. Mean arterial pressure (77.2+/-12.5 [CI 95%; 74.5-79.8] vs. 83.3+/-14.1 [CI 95%; 80.3-86.3] mm Hg; [ p<0.001]), cardiac index (4.03+/-0.89 [CI 95%; 3.83-4.22] vs. 3.46+/-0.82 [CI 95%; 3.28-3.64] L/m(2)/min; [ p<0.001]), systemic vascular resistance index (1,388+/-496 [CI 95%; 1,278-1,497] vs. 1,753+/-516 [CI 95%; 1,639-1,867] dynes x s/cm(5); [ p<0.001]), PO2/FIO2 ratio (204+/-87 [CI 95%; 185-223] vs. 238+/-82 [CI 95%; 220-256]; [ p<0.001]), significantly improved during 100 global treatments (pre- vs. post-treatment values). Intra-thoracic blood volume and extra-vascular lung water did not change across treatments. Vasopressor requirement was reduced: norepinephrine decrease from an infusion rate of 0.13+/-0.07 (CI 95%; 0.06-0.16) to 0 gamma/kg/min after a mean of 5.3+/-2.7 sessions. C reactive protein (CRP) significantly decreased (from 29.3+/-7.3 vs. 7.9+/-4.8; p<0.0001) during treatment. Survival was 90% at day 28 and 70% at day 90. Coupled plasmafiltration-adsorption was a feasible and safe extracorporeal treatment and exerted a remarkable improvement in the hemodynamics, the pulmonary function, and the outcome in septic shock patients with or without concomitant ARF. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Canada | 3 | 6% |
Italy | 2 | 4% |
Unknown | 43 | 90% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 11 | 23% |
Student > Postgraduate | 6 | 13% |
Professor > Associate Professor | 6 | 13% |
Other | 4 | 8% |
Student > Bachelor | 3 | 6% |
Other | 8 | 17% |
Unknown | 10 | 21% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 27 | 56% |
Biochemistry, Genetics and Molecular Biology | 2 | 4% |
Chemical Engineering | 2 | 4% |
Nursing and Health Professions | 2 | 4% |
Agricultural and Biological Sciences | 2 | 4% |
Other | 3 | 6% |
Unknown | 10 | 21% |