Language:

Hemoadsorption with CytoSorb shows a decreased observed versus expected 28-day all-cause mortality in ICU patients with septic shock: a propensity-score-weighted retrospective study

Critical care (London, England), 2019-09, Vol.23 (1), p.317-317, Article 317 [Peer Reviewed Journal]

COPYRIGHT 2019 BioMed Central Ltd. ;2019. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;The Author(s). 2019 ;ISSN: 1364-8535 ;EISSN: 1466-609X ;DOI: 10.1186/s13054-019-2588-1 ;PMID: 31533846

Full text available

Citations Cited by

Actions
1. Add to My Research
2. Remove from My Research
3. E-mail
4. Print
5. Permalink
6. Citation
7. EasyBib
8. EndNote
9. RefWorks
10. Delicious
11. Export RIS
12. Export BibTeX

Title:
Hemoadsorption with CytoSorb shows a decreased observed versus expected 28-day all-cause mortality in ICU patients with septic shock: a propensity-score-weighted retrospective study
Author: Brouwer, Willem Pieter ; Duran, Servet ; Kuijper, Martijn ; Ince, Can
Subjects: Absorption, Physiological ; Aged ; Biomedical filters ; Care and treatment ; Clinical trials ; Continuous Renal Replacement Therapy - instrumentation ; Continuous Renal Replacement Therapy - methods ; Critical care ; Critically ill persons ; Cytokines - therapeutic use ; Cytosorb ; Cytosorbent ; Equipment Design ; Female ; Health risk assessment ; Hemofiltration ; Hemofiltration - instrumentation ; Hemofiltration - methods ; Hospital Mortality ; Hospital patients ; Humans ; Intensive Care Units - organization & administration ; Intensive Care Units - statistics & numerical data ; Lactates ; Male ; Medical research ; Methods ; Middle Aged ; Mortality ; Netherlands ; Norepinephrine ; Odds Ratio ; Organ Dysfunction Scores ; Patient outcomes ; Phenols (Class of compounds) ; Prevention ; Propensity Score ; Renal replacement therapy ; Retrospective Studies ; Sepsis ; Septic shock ; Shock ; Shock, Septic - mortality ; Shock, Septic - therapy ; Therapeutics ; Treatment
Is Part Of: Critical care (London, England), 2019-09, Vol.23 (1), p.317-317, Article 317
Description: Innovative treatment modalities have not yet shown a clinical benefit in patients with septic shock. To reduce severe cytokinaemia, CytoSorb as an add-on to continuous renal replacement therapy (CRRT) showed promising results in case reports. However, there are no clinical trials investigating outcomes. In this investigator-initiated retrospective study, patients with septic shock were treated with CRRT + CytoSorb (n = 67) or CRRT alone (n = 49). The primary outcome was the 28-day all-cause mortality rate. Patients were weighted by stabilized inverse probability of treatment weights (sIPTW) to overcome differences in baseline characteristics. At the start of therapy, CytoSorb-treated patients had higher lactate levels (p < 0.001), lower mean arterial pressure (p = 0.007) and higher levels of noradrenaline (p < 0.001) compared to the CRRT group. For CytoSorb, the mean predicted mortality rate based on a SOFA of 13.8 (n = 67) was 75% (95%CI 71-79%), while the actual 28-day mortality rate was 48% (mean difference - 27%, 95%CI - 38 to - 15%, p < 0.001). For CRRT, based on a SOFA of 12.8 (n = 49), the mean predicted versus observed mortality was 68% versus 51% (mean difference - 16.9% [95%CI - 32.6 to - 1.2%, p = 0.035]). By sIPTW analysis, patients treated with CytoSorb had a significantly lower 28-day mortality rate compared to CRRT alone (53% vs. 72%, respectively, p = 0.038). Independent predictors of 28-day mortality in the CytoSorb group were the presence of pneumosepsis (adjusted odds ratio [aOR] 5.47, p = 0.029), higher levels of lactate at the start of CytoSorb (aOR 1.15, p = 0.031) and older age (aOR per 10 years 1.67, p = 0.034). CytoSorb was associated with a decreased observed versus expected 28-day all-cause mortality. By IPTW analysis, intervention with CytoSorb may be associated with a decreased all-cause mortality at 28 days compared to CRRT alone.
Publisher: England: BioMed Central Ltd
Language: English
Identifier: ISSN: 1364-8535
EISSN: 1466-609X
DOI: 10.1186/s13054-019-2588-1
PMID: 31533846
Source: AUTh Library subscriptions: ProQuest Central
Springer Open Access
MEDLINE
PubMed Central
Alma/SFX Local Collection
DOAJ Directory of Open Access Journals

Back to results list


INSPIRE LIBRARY - TON DUC THANG UNIVERSITY	(84-028) 37 755 057	Feedback
19 Nguyen Huu Tho St. Dist.7, HCM	thuvien@tdtu.edu.vn	Feedback

Hemoadsorption with CytoSorb shows a decreased observed versus expected 28-day all-cause mortality in ICU patients with septic shock: a propensity-score-weighted retrospective study

Searching Remote Databases, Please Wait