Plasma dia-filtration for severe sepsis

Area of Science:

• Critical Care Medicine
• Nephrology
• Hepatology

Background:

• Severe sepsis and multiple organ failure (MOF) carry high mortality rates, particularly with liver and renal dysfunction.
• Existing treatments for septic MOF have limited efficacy, necessitating novel therapeutic approaches.

Purpose of the Study:

• To evaluate the efficacy and safety of plasmapheresis-plasma diafiltration (PDF) in patients with severe sepsis and multiple organ failure.
• To assess the impact of PDF on 28-day mortality rates in critically ill patients.

Main Methods:

• PDF involves plasma filtration combined with dialysis, utilizing a specialized plasma separator.
• In a single-center study, 7 septic shock patients received PDF (average 7.4 sessions).
• A multicenter study included 33 severe sepsis patients with liver dysfunction who underwent PDF (average 12.0 sessions).

Main Results:

• In the single-center study, 28-day mortality was 29% (5/7 survivors).
• In the multicenter study, 28-day mortality was 36.4%, significantly lower than the predicted 68.0% for these patients.
• PDF was administered as a simple modality with a defined protocol for fluid replacement.

Conclusions:

• Plasmapheresis-plasma diafiltration (PDF) appears to be a feasible and potentially effective treatment for severe sepsis with multiple organ failure.
• PDF may offer a survival benefit in critically ill patients with septic MOF, including those with concurrent liver dysfunction.
• Further investigation into PDF as a therapeutic strategy for septic MOF is warranted.