The use of oXiris hemofilter in the initial continuous renal replacement therapy among patients with septic shock: A...

The impact of continuous renal replacement therapy (CRRT) with oXiris hemofilter (oXiris CRRT) on sepsis outcomes remain controversial. We aimed to investigate the association between the oXiris CRRT and subsequent outcomes in adult patients with septic shock.

This single-center, retrospective cohort study included adult patients with septic shock, who were admitted to the intensive care unit (ICU) of our tertiary referral hospital between 2019 and 2023, and underwent at least one CRRT session. Patients were categorized into two groups based on the initially hemofilter used (oXiris group vs. M100 group). A 1:1 propensity score matching was performed to compare the primary outcome 28-day vasopressor-free days.

Of 465 patients who met all eligibility criteria, 69 cases in the oXiris group were matched with 69 individuals in the M100 group. Compared with the M100 group, the use of oXiris CRRT was associated with longer 28-day vasopressor-free days (24 vs. 19 days, P = 0.04), shorter CRRT duration (72 vs. 117 h, P = 0.03), and a greater reduction in SOFA scores (-2 vs. 1, P = 0.004). However, competing risk analysis indicated no significant between-group difference in the cumulative incidence of vasopressor weaning after accounting for the competing risk of ICU mortality. Furthermore, no significant between-group differences were observed in changes in lactate, PCT, or IL-6 levels, fluid balance, ICU or hospital length of stay (LOS), or short-term mortality.

In this cohort of septic shock patients undergoing CRRT, unadjusted analyses demonstrated potential improvements in hemodynamic stability and organ function following oXiris therapy. Nevertheless, these preliminary signals were not confirmed by competing risk analysis of the primary outcome. Therefore, the clinical impacts of oXiris CRRT observed in the present study must be viewed cautiously, well-designed prospective investigations are warranted to verify its definitive therapeutic value.