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2013 ; 12
(ä): 681-92
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Coupled Plasma Filtration Adsorption (CPFA) plus Continuous Veno-Venous
Haemofiltration (CVVH) versus CVVH alone as an adjunctive therapy in the
treatment of sepsis
#MMPMID26600735
Hassan J
; Cader RA
; Kong NC
; Mohd M
; Rahman AR
; Hod R
EXCLI J
2013[]; 12
(ä): 681-92
PMID26600735
show ga
PURPOSE: To compare the efficacy of Coupled Plasma Filtration and Adsorption
(CPFA) plus Continuous Veno-Venous Haemofiltration (CVVH) versus CVVH alone as an
adjunct treatment of sepsis in terms of haemodynamic stability, inotropic
requirement and inflammatory mediators. DESIGN AND METHODS: Prospective
randomized controlled trial involving septic patients with/without acute kidney
injury (AKI) whom were randomized to receive CPFA + CVVH or CVVH alone.
Haemodynamic parameters including inotropic requirements and inflammatory
mediators [procalcitonin (PCT) and C reactive protein (CRP)] were measured.
RESULTS: Twenty-three patients [CPFA + CVVH (n = 11), CVVH (n = 12)] were
enrolled. Haemodynamic stability occurred earlier and sustained in the CPFA +
CVVH group with an increase in diastolic blood pressure (p = 0.001 vs. p = 0.226)
and mean arterial pressure (p = 0.001 vs. p = 0.575) at the end of treatment with
no increment in inotropic requirement. Both groups had a reduction in PCT and CRP
(CPFA + CVVH: p = 0.003, p = 0.026 and CVVH: p = 0.008, p = 0.071 respectively).
The length of intensive care unit stay, hospital stay and 30 day outcomes were
similar between the groups. There was an inverse association between serum
albumin and CRP (p = 0.018). Serum albumin positively correlated with systolic
blood pressure (p = 0.012) and diastolic blood pressure (p = 0.009). We found a
trend between CRP and length of hospital stay (p = 0.056). Patients with a lower
PCT at 24 h had a better outcome (survival) than those with a higher PCT (p =
0.045). CONCLUSION: CPFA is a feasible, albeit expensive adjunctive
extracorporeal treatment that may be superior to CVVH alone in the treatment of
severe sepsis.