Plasmapheresis in severe sepsis and septic shock: a prospective, randomised, controlled trial

Area of Science:

• Critical Care Medicine
• Renal Replacement Therapies
• Sepsis Pathophysiology

Background:

• Severe sepsis and septic shock are leading causes of intensive care unit mortality.
• Conventional treatments have limitations in reducing sepsis-related deaths.
• Investigating novel therapeutic strategies is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the therapeutic efficacy of plasmapheresis as an adjunct to standard care for severe sepsis and septic shock.
• To assess the safety profile of plasmapheresis in this patient population.
• To determine the impact of plasmapheresis on 28-day survival rates.

Main Methods:

• A prospective, randomized clinical trial was conducted.
• 106 patients with severe sepsis or septic shock were enrolled.
• Patients received either standard therapy or standard therapy plus plasmapheresis.

Main Results:

• The 28-day mortality rate was significantly lower in the plasmapheresis group (33.3%) compared to the control group (53.8%).
• Plasmapheresis demonstrated a relative risk reduction for fatal outcomes of 0.61.
• The procedure was associated with minimal adverse events, primarily transient hypotension and one allergic reaction.

Conclusions:

• Plasmapheresis shows potential as an effective adjuvant therapy for reducing mortality in severe sepsis and septic shock.
• The procedure is considered safe for treating septic patients.
• Further multicenter trials are recommended to confirm findings and identify patient subgroups who benefit most.