Interpretation of European and Asia Pacific expert recommendations on the use of adsorptive hemofiltration for sepsis_West China Medical Journal

Authors：

GUAN Mingjing ,  ZHANG Ling

Department of Nephrology / Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

ZHANG Ling, Email: zhangling_crrt@163.com

Keywords：

Sepsis; acute kidney injury; blood purification; adsorptive hemofiltration

DOI：

10.7507/1002-0179.202205126

Video：

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After comparative interpretation of the essentials and highlights of the expert recommendations based on European experience published in 2019 and the expert recommendations based on Asia Pacific experience published in 2021, this article summarizes the core principles of adsorptive hemofiltration for sepsis in following aspects, including patient selection, laboratory index, and key factors in the implementation of treatment (covering initiation timing and duration, choice of anticoagulant mode, discontinuation, etc) combined with the experience in West China Hospital of Sichuan University as well, to provide references for sepsis management with adsorptive hemofiltration in clinical practice.

Citation： GUAN Mingjing, ZHANG Ling. Interpretation of European and Asia Pacific expert recommendations on the use of adsorptive hemofiltration for sepsis. West China Medical Journal, 2022, 37(7): 996-1000. doi: 10.7507/1002-0179.202205126 Copy

1.	Pickkers P, Vassiliou T, Liguts V, et al. Sepsis management with a blood purification membrane: European experience. Blood Purif, 2019, 47(Suppl 3): 1-9.
2.	Zhang L, Cove M, Nguyen BG, et al. Adsorptive hemofiltration for sepsis management: expert recommendations based on the Asia Pacific experience. Chin Med J (Engl), 2021, 134(18): 2258-2260.
3.	Sakr Y, Jaschinski U, Wittebole X, et al. Sepsis in intensive care unit patients: worldwide data from the intensive care over nations audit. Open Forum Infect Dis, 2018, 5(12): ofy313.
4.	Abraham E, Singer M. Mechanisms of sepsis-induced organ dysfunction. Crit Care Med, 2007, 35(10): 2408-2416.
5.	Joannes-Boyau O, Honoré PM, Perez P, et al. High-volume versus standard-volume haemofiltration for septic shock patients with acute kidney injury (IVOIRE study): a multicentre randomized controlled trial. Intensive Care Med, 2013, 39(9): 1535-1546.
6.	Atan R, Peck L, Prowle J, et al. A double-blind randomized controlled trial of high cutoff versus standard hemofiltration in critically ill patients with acute kidney injury. Crit Care Med, 2018, 46(10): e988-e994.
7.	Marshall JC. Endotoxin in the pathogenesis of sepsis. Contrib Nephrol, 2010, 167: 1-13.
8.	Ronco C, Tetta C, Mariano F, et al. Interpreting the mechanisms of continuous renal replacement therapy in sepsis: the peak concentration hypothesis. Artif Organs, 2003, 27(9): 792-801.
9.	Honore PM, Jacobs R, Joannes-Boyau O, et al. Newly designed CRRT membranes for sepsis and SIRS--a pragmatic approach for bedside intensivists summarizing the more recent advances: a systematic structured review. ASAIO J, 2013, 59(2): 99-106.
10.	Guan M, Wang H, Tang X, et al. Continuous renal replacement therapy with adsorbing filter oxiris in acute kidney injury with septic shock: a retrospective observational study. Front Med (Lausanne), 2022, 9: 789623.
11.	Romaschin AD, Klein DJ, Marshall JC. Bench-to-bedside review: clinical experience with the endotoxin activity assay. Crit Care, 2012, 16(6): 248.
12.	Broman ME, Hansson F, Vincent JL, et al. Endotoxin and cytokine reducing properties of the oXiris membrane in patients with septic shock: a randomized crossover double-blind study. PLoS One, 2019, 14(8): e0220444.
13.	Zhang H, Zhu G, Yan L, et al. The absorbing filter Oxiris in severe coronavirus disease 2019 patients: a case series. Artif Organs, 2020, 44(12): 1296-1302.
14.	Schwindenhammer V, Girardot T, Chaulier K, et al. oXiris® use in septic shock: experience of two french centres. Blood Purif, 2019, 47(Suppl 3): 1-7.
15.	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.
16.	Kellum JA, Lameire N, KDIGO AKI Guideline Work Group. Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (Part 1). Crit Care, 2013, 17(1): 204.
17.	中华医学会肾脏病学分会, 中国研究型医院学会肾脏病学专业委员会. 特殊血液净化技术应用于重症新型冠状病毒肺炎的专家共识. 中华内科杂志, 2020, 59(11): 847-853.
18.	Marshall JC, Walker PM, Foster DM, et al. Measurement of endotoxin activity in critically ill patients using whole blood neutrophil dependent chemiluminescence. Crit Care, 2002, 6(4): 342-348.

1. Pickkers P, Vassiliou T, Liguts V, et al. Sepsis management with a blood purification membrane: European experience. Blood Purif, 2019, 47(Suppl 3): 1-9.
2. Zhang L, Cove M, Nguyen BG, et al. Adsorptive hemofiltration for sepsis management: expert recommendations based on the Asia Pacific experience. Chin Med J (Engl), 2021, 134(18): 2258-2260.
3. Sakr Y, Jaschinski U, Wittebole X, et al. Sepsis in intensive care unit patients: worldwide data from the intensive care over nations audit. Open Forum Infect Dis, 2018, 5(12): ofy313.
4. Abraham E, Singer M. Mechanisms of sepsis-induced organ dysfunction. Crit Care Med, 2007, 35(10): 2408-2416.
5. Joannes-Boyau O, Honoré PM, Perez P, et al. High-volume versus standard-volume haemofiltration for septic shock patients with acute kidney injury (IVOIRE study): a multicentre randomized controlled trial. Intensive Care Med, 2013, 39(9): 1535-1546.
6. Atan R, Peck L, Prowle J, et al. A double-blind randomized controlled trial of high cutoff versus standard hemofiltration in critically ill patients with acute kidney injury. Crit Care Med, 2018, 46(10): e988-e994.
7. Marshall JC. Endotoxin in the pathogenesis of sepsis. Contrib Nephrol, 2010, 167: 1-13.
8. Ronco C, Tetta C, Mariano F, et al. Interpreting the mechanisms of continuous renal replacement therapy in sepsis: the peak concentration hypothesis. Artif Organs, 2003, 27(9): 792-801.
9. Honore PM, Jacobs R, Joannes-Boyau O, et al. Newly designed CRRT membranes for sepsis and SIRS--a pragmatic approach for bedside intensivists summarizing the more recent advances: a systematic structured review. ASAIO J, 2013, 59(2): 99-106.
10. Guan M, Wang H, Tang X, et al. Continuous renal replacement therapy with adsorbing filter oxiris in acute kidney injury with septic shock: a retrospective observational study. Front Med (Lausanne), 2022, 9: 789623.
11. Romaschin AD, Klein DJ, Marshall JC. Bench-to-bedside review: clinical experience with the endotoxin activity assay. Crit Care, 2012, 16(6): 248.
12. Broman ME, Hansson F, Vincent JL, et al. Endotoxin and cytokine reducing properties of the oXiris membrane in patients with septic shock: a randomized crossover double-blind study. PLoS One, 2019, 14(8): e0220444.
13. Zhang H, Zhu G, Yan L, et al. The absorbing filter Oxiris in severe coronavirus disease 2019 patients: a case series. Artif Organs, 2020, 44(12): 1296-1302.
14. Schwindenhammer V, Girardot T, Chaulier K, et al. oXiris® use in septic shock: experience of two french centres. Blood Purif, 2019, 47(Suppl 3): 1-7.
15. 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.
16. Kellum JA, Lameire N, KDIGO AKI Guideline Work Group. Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (Part 1). Crit Care, 2013, 17(1): 204.
17. 中华医学会肾脏病学分会, 中国研究型医院学会肾脏病学专业委员会. 特殊血液净化技术应用于重症新型冠状病毒肺炎的专家共识. 中华内科杂志, 2020, 59(11): 847-853.
18. Marshall JC, Walker PM, Foster DM, et al. Measurement of endotoxin activity in critically ill patients using whole blood neutrophil dependent chemiluminescence. Crit Care, 2002, 6(4): 342-348.

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