AN69 Filter Membranes with High Ultrafiltration Rates during Continuous Venovenous Hemofiltration Reduce Mortality in Patients with Sepsis-Induced Multiorgan Dysfunction Syndrome
Polyacrylonitrile (AN69) filter membranes adsorb cytokines during continuous venovenous hemofiltration (CVVH). Although high-volume hemofiltration has shown limited benefits, the dose-effect relationship in CVVH with AN69 membranes on severe sepsis remains undetermined. This multi-centered study enr...
Guardado en:
| Autores principales: | , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
MDPI AG
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/e6ad06d4baf54389a6e1622a854a5cc9 |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:e6ad06d4baf54389a6e1622a854a5cc9 |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:e6ad06d4baf54389a6e1622a854a5cc92021-11-25T18:19:42ZAN69 Filter Membranes with High Ultrafiltration Rates during Continuous Venovenous Hemofiltration Reduce Mortality in Patients with Sepsis-Induced Multiorgan Dysfunction Syndrome10.3390/membranes111108372077-0375https://doaj.org/article/e6ad06d4baf54389a6e1622a854a5cc92021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0375/11/11/837https://doaj.org/toc/2077-0375Polyacrylonitrile (AN69) filter membranes adsorb cytokines during continuous venovenous hemofiltration (CVVH). Although high-volume hemofiltration has shown limited benefits, the dose-effect relationship in CVVH with AN69 membranes on severe sepsis remains undetermined. This multi-centered study enrolled 266 patients with sepsis-induced multiorgan dysfunction syndrome (MODS) who underwent CVVH with AN69 membranes between 2014 and 2015. We investigated the effects of ultrafiltration rates (UFR) on mortality. We categorized patients that were treated with UFR of 20–25 mL/kg/h as the standard UFR group (<i>n</i> = 124) and those that were treated with a UFR >25 mL/kg/h as the high UFR group (<i>n</i> = 142). Among the patient characteristics, the baseline estimated glomerular filtration rates (eGFR) <60 mL/min/1.73 m<sup>2</sup>, hemoglobin levels <10 g/dL, and a sequential organ failure assessment (SOFA) score ≥15 at CVVH initiation were independently associated with in-hospital mortality. In the subgroup analysis, for patients with SOFA scores that were ≥15, the 90-day survival rate was higher in the high UFR group than in the standard UFR group (HR 0.54, CI: 0.36–0.79, <i>p</i> = 0.005). We concluded that in patients with sepsis-induced MODS, SOFA scores ≥15 predicted a poor rate of survival. High UFR setting >25 mL/kg/h in CVVH with AN69 membranes may reduce the mortality risk in these high-risk patients.Kuo-Hua LeeShuo-Ming OuMing-Tsun TsaiWei-Cheng TsengChih-Yu YangYao-Ping LinDer-Cherng TarngMDPI AGarticlecritical medicinemultiple organ failureintensive care unitblood purificationChemical technologyTP1-1185Chemical engineeringTP155-156ENMembranes, Vol 11, Iss 837, p 837 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
critical medicine multiple organ failure intensive care unit blood purification Chemical technology TP1-1185 Chemical engineering TP155-156 |
| spellingShingle |
critical medicine multiple organ failure intensive care unit blood purification Chemical technology TP1-1185 Chemical engineering TP155-156 Kuo-Hua Lee Shuo-Ming Ou Ming-Tsun Tsai Wei-Cheng Tseng Chih-Yu Yang Yao-Ping Lin Der-Cherng Tarng AN69 Filter Membranes with High Ultrafiltration Rates during Continuous Venovenous Hemofiltration Reduce Mortality in Patients with Sepsis-Induced Multiorgan Dysfunction Syndrome |
| description |
Polyacrylonitrile (AN69) filter membranes adsorb cytokines during continuous venovenous hemofiltration (CVVH). Although high-volume hemofiltration has shown limited benefits, the dose-effect relationship in CVVH with AN69 membranes on severe sepsis remains undetermined. This multi-centered study enrolled 266 patients with sepsis-induced multiorgan dysfunction syndrome (MODS) who underwent CVVH with AN69 membranes between 2014 and 2015. We investigated the effects of ultrafiltration rates (UFR) on mortality. We categorized patients that were treated with UFR of 20–25 mL/kg/h as the standard UFR group (<i>n</i> = 124) and those that were treated with a UFR >25 mL/kg/h as the high UFR group (<i>n</i> = 142). Among the patient characteristics, the baseline estimated glomerular filtration rates (eGFR) <60 mL/min/1.73 m<sup>2</sup>, hemoglobin levels <10 g/dL, and a sequential organ failure assessment (SOFA) score ≥15 at CVVH initiation were independently associated with in-hospital mortality. In the subgroup analysis, for patients with SOFA scores that were ≥15, the 90-day survival rate was higher in the high UFR group than in the standard UFR group (HR 0.54, CI: 0.36–0.79, <i>p</i> = 0.005). We concluded that in patients with sepsis-induced MODS, SOFA scores ≥15 predicted a poor rate of survival. High UFR setting >25 mL/kg/h in CVVH with AN69 membranes may reduce the mortality risk in these high-risk patients. |
| format |
article |
| author |
Kuo-Hua Lee Shuo-Ming Ou Ming-Tsun Tsai Wei-Cheng Tseng Chih-Yu Yang Yao-Ping Lin Der-Cherng Tarng |
| author_facet |
Kuo-Hua Lee Shuo-Ming Ou Ming-Tsun Tsai Wei-Cheng Tseng Chih-Yu Yang Yao-Ping Lin Der-Cherng Tarng |
| author_sort |
Kuo-Hua Lee |
| title |
AN69 Filter Membranes with High Ultrafiltration Rates during Continuous Venovenous Hemofiltration Reduce Mortality in Patients with Sepsis-Induced Multiorgan Dysfunction Syndrome |
| title_short |
AN69 Filter Membranes with High Ultrafiltration Rates during Continuous Venovenous Hemofiltration Reduce Mortality in Patients with Sepsis-Induced Multiorgan Dysfunction Syndrome |
| title_full |
AN69 Filter Membranes with High Ultrafiltration Rates during Continuous Venovenous Hemofiltration Reduce Mortality in Patients with Sepsis-Induced Multiorgan Dysfunction Syndrome |
| title_fullStr |
AN69 Filter Membranes with High Ultrafiltration Rates during Continuous Venovenous Hemofiltration Reduce Mortality in Patients with Sepsis-Induced Multiorgan Dysfunction Syndrome |
| title_full_unstemmed |
AN69 Filter Membranes with High Ultrafiltration Rates during Continuous Venovenous Hemofiltration Reduce Mortality in Patients with Sepsis-Induced Multiorgan Dysfunction Syndrome |
| title_sort |
an69 filter membranes with high ultrafiltration rates during continuous venovenous hemofiltration reduce mortality in patients with sepsis-induced multiorgan dysfunction syndrome |
| publisher |
MDPI AG |
| publishDate |
2021 |
| url |
https://doaj.org/article/e6ad06d4baf54389a6e1622a854a5cc9 |
| work_keys_str_mv |
AT kuohualee an69filtermembraneswithhighultrafiltrationratesduringcontinuousvenovenoushemofiltrationreducemortalityinpatientswithsepsisinducedmultiorgandysfunctionsyndrome AT shuomingou an69filtermembraneswithhighultrafiltrationratesduringcontinuousvenovenoushemofiltrationreducemortalityinpatientswithsepsisinducedmultiorgandysfunctionsyndrome AT mingtsuntsai an69filtermembraneswithhighultrafiltrationratesduringcontinuousvenovenoushemofiltrationreducemortalityinpatientswithsepsisinducedmultiorgandysfunctionsyndrome AT weichengtseng an69filtermembraneswithhighultrafiltrationratesduringcontinuousvenovenoushemofiltrationreducemortalityinpatientswithsepsisinducedmultiorgandysfunctionsyndrome AT chihyuyang an69filtermembraneswithhighultrafiltrationratesduringcontinuousvenovenoushemofiltrationreducemortalityinpatientswithsepsisinducedmultiorgandysfunctionsyndrome AT yaopinglin an69filtermembraneswithhighultrafiltrationratesduringcontinuousvenovenoushemofiltrationreducemortalityinpatientswithsepsisinducedmultiorgandysfunctionsyndrome AT dercherngtarng an69filtermembraneswithhighultrafiltrationratesduringcontinuousvenovenoushemofiltrationreducemortalityinpatientswithsepsisinducedmultiorgandysfunctionsyndrome |
| _version_ |
1718411352748326912 |