Kidney Week

Abstract: TH-PO231

Oxiris Membrane Performance in Patients with Septic Shock and Continuous Kidney Replacement Therapy Requirement: A Randomized Controlled Trial

Session Information

• Hemodialysis, Hemodiafiltration, and Frequent Dialysis
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Fueyo, Omar, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico

Omar Fueyo, MD

• Caballero-Islas, Adrián Esteban, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico

Adrián Esteban Caballero-Islas, MD

• Arvizu Hernández, Mauricio, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico

Mauricio Arvizu Hernández, MD

• Correa-Rotter, Ricardo, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico

Ricardo Correa-Rotter, MD

• Galindo, Pablo E., Hospital General de Mexico Dr Eduardo Liceaga, Ciudad de Mexico, Ciudad de Mexico, Mexico

Pablo E. Galindo, MD

• Cruz Mendoza, Néstor Humberto, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico

Néstor Humberto Cruz Mendoza, MD

• Vega, Olynka, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico

Olynka Vega, MD, MS

Background

^{Highly selective semipermeable Oxiris membranes have shown to provide endotoxin adsorption and removal of different cytokines which could improve hemodynamic stability in patients with septic shock and continuous kidney replacement therapy (CKRT) requirement. The aim of this study was to compare the clinical efficacy of Oxiris membrane vs a conventional AN69 standard membrane to maintain the mean arterial pressure (MAP) after 72 hours in critically ill patients with CKRT requirement}

Methods

^{Multicenter randomized controlled trial in critically ill patients and CKRT requirement. Patients were randomized to receive continuous veno-venous hemodiafiltration using either an AN69 standard membrane or an AN69 Oxiris membrane. Regional citrate anticoagulation was used, all patients had a prescribed dose of 30mL/kg/h for 72 hours, the filters were changed every 24h. Clinical variables were registered, vasopressor dependency index was calculated to express relationship between vasopressor dose and MAP}

Results

^{Originally 36 patients were intended to be included. At the time of this cut point 30 patients have been included, 15 (50%) in the Oxiris group, 14 (46%%) in the control group and 1 (3%) had to be excluded because of death in the first 24 hours. Most common infection was pneumonia, 28% due to COVID-19, mean initial SOFA was 11 points. There were no differences in MAP between groups (Oxiris vs. Control) at 0, 24, 48 and 72 h; 66 vs 68, 71 vs 74, 73 vs 77 and 73 vs 79 respectively. Figure 1. The rate of vasopressors was not different as shown in Figure 2. Fluid removal tended to be greater in the control group with a median rate of 1.2 vs 0.5 (p = 0.03) at 24 h, 0.9 vs 1.0 at 48 h (p=0.72), and at 72 h with a rate of 1.5 vs 0.7 (p=0.03). There were no differences in daily fluid balance}

Conclusion

^{In this study there were no differences in the requirement of vasopressors to maintain hemodynamic stability in patients with septic shock and CKRT using Oxiris membrane compared to standard membrane.}

MAP and Vasopressor Index at baseline, 24, 48 and 72 h