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High-volume haemofiltration for sepsis in adults

Overview of attention for article published in Cochrane database of systematic reviews, February 2017
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3 tweeters
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75 Mendeley
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Title
High-volume haemofiltration for sepsis in adults
Published in
Cochrane database of systematic reviews, February 2017
DOI 10.1002/14651858.cd008075.pub3
Pubmed ID
Authors

Borthwick, Emma MJ, Hill, Christopher J, Rabindranath, Kannaiyan S, Maxwell, Alexander P, McAuley, Danny F, Blackwood, Bronagh

Abstract

Severe sepsis and septic shock are leading causes of death in the intensive care unit (ICU), despite advances in the treatment of patients with severe sepsis and septic shock, including early recognition, appropriate treatment with antibiotics and support of organs that may have been affected by the illness. High-volume haemofiltration (HVHF) is a blood purification technique that may improve outcomes in severe sepsis or septic shock. The technique of HVHF has evolved from renal replacement therapies used in the ICU to treat critically ill patients with acute kidney injury (AKI). This review was first published in 2013 and was updated in 2016. To investigate whether HVHF improves outcomes in critically ill adults admitted to the intensive care unit with severe sepsis or septic shock. The primary outcome of this systematic review is patient mortality; secondary outcomes include duration of stay, severity of organ dysfunction and adverse events. For this updated version, we extended searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Latin American Caribbean Health Sciences Literature (LILACS), Web of Science and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) to 31 December 2015. The original search was performed in 2011. We also searched trials registers. We included randomized controlled trials (RCTs) and quasi-randomized trials comparing HVHF or high-volume haemodiafiltration versus standard or usual dialysis therapy, as well as RCTs and quasi-randomized trials comparing HVHF or high-volume haemodiafiltration versus no similar dialysis therapy. These studies involved adults treated in critical care units. Three review authors independently extracted data and assessed trial quality. We sought additional information from trialists as required. We included four randomized trials involving 200 participants. Owing to small numbers of studies and participants, it was not possible to combine data for all outcomes. Two trials reported 28-day mortality, and one trial reported hospital mortality; in the third trial, the number of deaths stated did not match the quoted mortality rates. The pooled risk ratio (95% confidence interval) for 28-day mortality associated with HVHF was 0.89 (0.60 to 1.32, two trials, 146 participants, low-quality evidence). One study (137 participants, low-quality evidence) reported length of stay in the ICU. Two trials (170 participants, low-quality evidence) reported organ dysfunction, but we could not pool results owing to reporting differences. Three studies (189 participants, low-quality evidence) reported on haemodynamic changes, but we could not pool results owing to reporting differences. Investigators reported no adverse events. Overall, the included studies had low risk of bias. Investigators reported no adverse effects of HVHF (low-quality evidence). The results of this meta-analysis show that very few studies have been conducted to investigate the use of HVHF in critically ill patients with severe sepsis or septic shock (four studies, 201 participants, low-quality evidence). Researchers should consider additional randomized controlled trials that are large and multi-centred and have clinically relevant outcome measures. The cost-effectiveness of HVHF should also be studied. .

Twitter Demographics

The data shown below were collected from the profiles of 3 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 75 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 2 3%
Japan 2 3%
India 1 1%
Italy 1 1%
Norway 1 1%
Colombia 1 1%
Unknown 67 89%

Demographic breakdown

Readers by professional status Count As %
Student > Master 13 17%
Student > Ph. D. Student 11 15%
Other 10 13%
Researcher 10 13%
Student > Bachelor 7 9%
Other 24 32%
Readers by discipline Count As %
Medicine and Dentistry 55 73%
Nursing and Health Professions 6 8%
Unspecified 5 7%
Engineering 3 4%
Social Sciences 2 3%
Other 4 5%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 August 2017.
All research outputs
#4,097,903
of 8,594,058 outputs
Outputs from Cochrane database of systematic reviews
#6,933
of 8,688 outputs
Outputs of similar age
#139,689
of 290,330 outputs
Outputs of similar age from Cochrane database of systematic reviews
#141
of 149 outputs
Altmetric has tracked 8,594,058 research outputs across all sources so far. This one has received more attention than most of these and is in the 50th percentile.
So far Altmetric has tracked 8,688 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 18.9. This one is in the 18th percentile – i.e., 18% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 290,330 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 49th percentile – i.e., 49% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 149 others from the same source and published within six weeks on either side of this one. This one is in the 4th percentile – i.e., 4% of its contemporaries scored the same or lower than it.