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- 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.
- Authors
Chelazzi, Cosimo; Villa, Gianluca; D'alfonso, Maria Grazia; Mancinelli, Paola; Consales, Guglielmo; Berardi, Margherita; De Gaudio, angelo Raffaele; Romagnoli, Stefano
- Abstract
Background: 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. Methods: 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. Results: 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. Conclusion: 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.
- Subjects
HEMODIALYZERS; VASOCONSTRICTORS; PATHOGENIC microorganisms
- Publication
Blood Purification, 2016, Vol 42, Issue 3, p186
- ISSN
0253-5068
- Publication type
Case Study
- DOI
10.1159/000446978