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Blood purification in sepsis and systemic inflammation
Ying Feng1, Jin-Yu Peng2, Zhiyong Peng1,3
1Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Center of Critical Care Clinical Research of Hubei Province, Wuhan.
Current Opinion in Critical Care
|September 28, 2021
Summary
Blood purification may help manage sepsis and COVID-19 by reducing harmful substances. However, its impact on survival and hemodynamics requires more research from ongoing trials.
Area of Science:
- Critical care medicine
- Nephrology
- Infectious diseases
Background:
- Sepsis and septic shock are leading causes of death, with limited treatment options.
- Critically ill COVID-19 patients share similarities with sepsis, suggesting potential benefits from similar therapies.
Purpose of the Study:
- To review the role of blood purification as an adjunctive therapy for sepsis and COVID-19.
- To evaluate the effectiveness of blood purification in managing cytokine storm and endotoxin activity.
Main Methods:
- Review of recent clinical trials focusing on hemadsorption materials for sepsis and COVID-19.
- Analysis of studies investigating the impact of blood purification on cytokine levels, endotoxin activity, and hemodynamics.
Main Results:
- Blood purification showed a tendency to decrease cytokine levels and endotoxin activity.
- Observed improvements in hemodynamics were noted, but results remain controversial.
- Evidence regarding the effect on mortality is still inconclusive.
Conclusions:
- Blood purification therapy shows promise in reducing inflammatory markers in sepsis and COVID-19.
- Further well-designed, large-scale trials are necessary to establish optimal protocols, including timing, indications, and specific blood purification methods.
- More research is needed to clarify the impact on mortality and hemodynamics.
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