oXiris - Clinical practice of endotoxin adsorption_West China Medical Journal

Authors：

 Mark R. Marshall ^1,2 , ZHANG Ling ³ , WANG Minmin ² , LIU Xinyu ⁴ , ZHOU Yu ⁴

1. Department of Renal Medicine, Middlemore Hospital, Auckland 93311, New Zealand;
2. Medical Affairs, Baxter Healthcare (Asia) Pte Ltd., Singapore 189720;
3. Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
4. Medical Affairs, Baxter (China) Investment Co., Ltd., Shanghai 200031, P. R. China;

Corresponding author：

Mark R. Marshall, Email: markrogermarshall@icloud.com

Keywords：

Sepsis; Endotoxin; Endotoxin removal; Prognosis; Adsorptive membrane

DOI：

10.7507/1002-0179.201806041

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection, and is the leading cause of death in intensive care unit patients due to limited therapies currently. As is known to all, endotoxin is important in the pathogenesis of sepsis, whereby infection triggers a systemic inflammatory response, resulting in release of pro- and anti-inflammatory cytokines, which are thought to be responsible for the tissue damage that occurs in sepsis patients. Therefore, removing endotoxins is considered as an effective way to improve the conditions of sepsis patients. Both Toraymaxin (PMX) and adsorptive membrane such as oXiris can remove endotoxins by adsorption, and in this review we will summarize current studies, included in vitro study, animal study, and clinical research to show the benefit from endotoxin removal by oXiris, and also give some suggestions about oXiris clinical practice from experienced experts.

Citation： Mark R. Marshall, ZHANG Ling, WANG Minmin, LIU Xinyu, ZHOU Yu. oXiris - Clinical practice of endotoxin adsorption. West China Medical Journal, 2018, 33(7): 797-800. doi: 10.7507/1002-0179.201806041 Copy

1.	Fleischmann C, Scherag A, Adhikari NK, et al. Assessment of global incidence and mortality of hospital-treated sepsis. current estimates and limitations. Am J Respir Crit Care Med, 2016, 193(3): 259-272.
2.	Cruz DN, Antonelli M, Fumagalli R, et al. Early use of polymyxin B hemoperfusion in abdominal septic shock: the EUPHAS randomized controlled trial. JAMA, 2009, 301(23): 2445-2452.
3.	Iba T, Fowler L. Is polymyxin B-immobilized fiber column ineffective for septic shock? A discussion on the press release for EUPHRATES trial. J Intensive Care, 2017, 5: 40.
4.	Rimmelé T, Assadi A, Cattenoz M, et al. High-volume haemofiltration with a new haemofiltration membrane having enhanced adsorption properties in septic pigs. Nephrol Dial Transplant, 2009, 24(2): 421-427.
5.	Malard B, Lambert C, Kellum JA. In vitro comparison of the adsorption of inflammatory mediators by blood purification devices. Intensive Care Med Exp, 2018, 6(1): 12.
6.	Monard C, Rimmeléa T, Chuasuwan A, et al. Comparaison de duex techniques de purification sanguine extracorporelle dans un modéle de rat en choc septique. Ann Fr Anesth Reanim, 2013, 32(Suppl 1): A339-A340.
7.	Candidi F, Covotta M, Caravetta P, et al. Continuous renal replacement therapy with an adsorbent membrane in postoperative septic cardiac patients: a clinical experience. EACTA, 2012: 211.
8.	Turani F, Candidi F, Barchetta R, et al. Continuous renal replacement therapy with the adsorbent membrane oXiris in septic patients: a clinical experience. Crit Care, 2013, 17(Suppl 2): P63.
9.	Hui WF, Chan WKY. Role of hemofilter with endotoxin adsorption capacity in management of septic shock. Crit Care Shock, 2017, 20: 119-123.
10.	Prato F, Tengattini M, Tasso G, et al. Use of oXiris during continuous renal replacement therapy (CRRT) in patients with septic shock and AKI: a case series. Intensive Care Med Exp, 2017, 5(Suppl 2): 0858.
11.	Mikolasevic I, Orlic L, Devčić B, et al. Application of oxiris® membrane in septic acute kidney injury due to gram-negative bacterial infection. Acta Medica Croatica, 2014: 149-155.
12.	Tang KB, Chau CM, Lam KN. Effect of oXiris haemodiafiltration in shock reversal for intraabdominal sepsis and septic shock: a case control series. Intensive Care Med Exp, 2016, 4(Suppl 1): A381.
13.	Shum HP, Chan KC, Kwan MC, et al. Application of endotoxin and cytokine adsorption haemofilter in septic acute kidney injury due to Gram-negative bacterial infection. Hong Kong Med J, 2013, 19(6): 491-497.
14.	Cocchi E, Bonaudo R, Mattozzi F, et al. Multiorgan failure with severe rhabdomyolyis after cardiac transplant successfully treated with CRRT with AN69 heparin engrafted filter oXiris. Pediatr Nephrol, 2017, 32: 1692.
15.	Turani F, Belli AB, Martni SM, et al. oXiris membrane decreases endotoxin during RRT in septic patients with basal EAA>0.6. Crit Care, 2016, 20(Suppl 2): P196.
16.	Adamik BA, Smiechowicz JS, Zielinski SZ, et al. Use of extracorporeal endotoxin elimination therapy for septic shock. Crit Care, 2013, 17(Suppl 2): P66.
17.	Govil, Deepak, Gupta, et al. Cytokine adsorption in sepsis: correct timing can predict the favorable outcome. Kidney Int Rep, 2017, 2: S29.
18.	Musielak A, Silska M, Lipkowska K, et al. Septex® and oXiris® - new systems of blood purification in SIRS treatment in children. Pediatr Nephrol, 2012, 27: 1770.
19.	Imahase H, Sakamoto Y, Kusunose M, et al. Examination of blood filtration membrane removal ability of HMGB1. Crit Care, 2012, 16(Suppl 3): P10.
20.	Plata-Menchaca EP, Sabater-Riera J, Estruch M, et al. Pilot study to evaluate the use of an adsorption membrane (OXIRIS®) during cardiopulmonary bypass surgery. Intensive Care Med Exp, 2016, 4(Suppl 1): A754.
21.	Caravetta P, Lappa A, Menichetti S, et al. Continuous renal replacement therapy combined with endotoxins removal in septic patients: a pilot study// 18th Annual International Conference on Continuous Renal Replacement Therapies (CRRT). San Diego: 18th International Conference on CRRT, 2013: 41.
22.	Harenshi K. Inflamm Res, 2010, 59(Suppl 1): S63.
23.	Martin O, Allzouchiche B, Capellier G, et al. Une nouvelle membrane préhéparinée pour hemofiltration continue en reanimation. Réanimation, 2009, 18 (Suppl 1): S17.
24.	Caravetta P, Lappa A, Seven L, et al. Clinical evaluation of new CRRT membrane with endotoxins and cytokines removal proprieties. Simposio Mostra Anestesia Rianimazione E Terepia Instensiva, Milan, 2011.
25.	Kaukonen KM, Bailey M, Suzuki S, et al. Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000-2012. JAMA, 2014, 311(13): 1308-1316.

1. Fleischmann C, Scherag A, Adhikari NK, et al. Assessment of global incidence and mortality of hospital-treated sepsis. current estimates and limitations. Am J Respir Crit Care Med, 2016, 193(3): 259-272.
2. Cruz DN, Antonelli M, Fumagalli R, et al. Early use of polymyxin B hemoperfusion in abdominal septic shock: the EUPHAS randomized controlled trial. JAMA, 2009, 301(23): 2445-2452.
3. Iba T, Fowler L. Is polymyxin B-immobilized fiber column ineffective for septic shock? A discussion on the press release for EUPHRATES trial. J Intensive Care, 2017, 5: 40.
4. Rimmelé T, Assadi A, Cattenoz M, et al. High-volume haemofiltration with a new haemofiltration membrane having enhanced adsorption properties in septic pigs. Nephrol Dial Transplant, 2009, 24(2): 421-427.
5. Malard B, Lambert C, Kellum JA. In vitro comparison of the adsorption of inflammatory mediators by blood purification devices. Intensive Care Med Exp, 2018, 6(1): 12.
6. Monard C, Rimmeléa T, Chuasuwan A, et al. Comparaison de duex techniques de purification sanguine extracorporelle dans un modéle de rat en choc septique. Ann Fr Anesth Reanim, 2013, 32(Suppl 1): A339-A340.
7. Candidi F, Covotta M, Caravetta P, et al. Continuous renal replacement therapy with an adsorbent membrane in postoperative septic cardiac patients: a clinical experience. EACTA, 2012: 211.
8. Turani F, Candidi F, Barchetta R, et al. Continuous renal replacement therapy with the adsorbent membrane oXiris in septic patients: a clinical experience. Crit Care, 2013, 17(Suppl 2): P63.
9. Hui WF, Chan WKY. Role of hemofilter with endotoxin adsorption capacity in management of septic shock. Crit Care Shock, 2017, 20: 119-123.
10. Prato F, Tengattini M, Tasso G, et al. Use of oXiris during continuous renal replacement therapy (CRRT) in patients with septic shock and AKI: a case series. Intensive Care Med Exp, 2017, 5(Suppl 2): 0858.
11. Mikolasevic I, Orlic L, Devčić B, et al. Application of oxiris® membrane in septic acute kidney injury due to gram-negative bacterial infection. Acta Medica Croatica, 2014: 149-155.
12. Tang KB, Chau CM, Lam KN. Effect of oXiris haemodiafiltration in shock reversal for intraabdominal sepsis and septic shock: a case control series. Intensive Care Med Exp, 2016, 4(Suppl 1): A381.
13. Shum HP, Chan KC, Kwan MC, et al. Application of endotoxin and cytokine adsorption haemofilter in septic acute kidney injury due to Gram-negative bacterial infection. Hong Kong Med J, 2013, 19(6): 491-497.
14. Cocchi E, Bonaudo R, Mattozzi F, et al. Multiorgan failure with severe rhabdomyolyis after cardiac transplant successfully treated with CRRT with AN69 heparin engrafted filter oXiris. Pediatr Nephrol, 2017, 32: 1692.
15. Turani F, Belli AB, Martni SM, et al. oXiris membrane decreases endotoxin during RRT in septic patients with basal EAA>0.6. Crit Care, 2016, 20(Suppl 2): P196.
16. Adamik BA, Smiechowicz JS, Zielinski SZ, et al. Use of extracorporeal endotoxin elimination therapy for septic shock. Crit Care, 2013, 17(Suppl 2): P66.
17. Govil, Deepak, Gupta, et al. Cytokine adsorption in sepsis: correct timing can predict the favorable outcome. Kidney Int Rep, 2017, 2: S29.
18. Musielak A, Silska M, Lipkowska K, et al. Septex® and oXiris® - new systems of blood purification in SIRS treatment in children. Pediatr Nephrol, 2012, 27: 1770.
19. Imahase H, Sakamoto Y, Kusunose M, et al. Examination of blood filtration membrane removal ability of HMGB1. Crit Care, 2012, 16(Suppl 3): P10.
20. Plata-Menchaca EP, Sabater-Riera J, Estruch M, et al. Pilot study to evaluate the use of an adsorption membrane (OXIRIS®) during cardiopulmonary bypass surgery. Intensive Care Med Exp, 2016, 4(Suppl 1): A754.
21. Caravetta P, Lappa A, Menichetti S, et al. Continuous renal replacement therapy combined with endotoxins removal in septic patients: a pilot study// 18th Annual International Conference on Continuous Renal Replacement Therapies (CRRT). San Diego: 18th International Conference on CRRT, 2013: 41.
22. Harenshi K. Inflamm Res, 2010, 59(Suppl 1): S63.
23. Martin O, Allzouchiche B, Capellier G, et al. Une nouvelle membrane préhéparinée pour hemofiltration continue en reanimation. Réanimation, 2009, 18 (Suppl 1): S17.
24. Caravetta P, Lappa A, Seven L, et al. Clinical evaluation of new CRRT membrane with endotoxins and cytokines removal proprieties. Simposio Mostra Anestesia Rianimazione E Terepia Instensiva, Milan, 2011.
25. Kaukonen KM, Bailey M, Suzuki S, et al. Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000-2012. JAMA, 2014, 311(13): 1308-1316.

Previous Article
Nomenclature for renal replacement therapy and blood purification techniques in critically ill patients
Next Article
Nafamostat mesilate in anticoagulation of continuous renal replacement therapy

West China Medical Journal

oXiris - Clinical practice of endotoxin adsorption

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content