Impact of HA60 hemoperfusion on inflammatory markers and organ function in critically ill children with septic shock

In this study, the efficacy and safety of HA60 hemoadsorption in pediatric sepsis/septic shock and multiple organ dysfunction were evaluated.

Eight patients who underwent HA60 hemoperfusion were analyzed. In addition to standard sepsis treatment, all patients received a single 6-h session with the HA60 filter. Along with the vasoactive inotropic score (VIS), CRP, IL-6, PCT, ferritin, lactate, AST, ALT, LDH, and bilirubin levels were evaluated at 0, 24, 48, and 72 h.

The median age was 44.5 months, and 62.5% of the patients were male; 75% had underlying heart disease, all patients received invasive mechanical ventilation and CRRT, and 62.5% required ECMO. Following HA60, a significant decrease in CRP was observed up to 72 h (from 224.7 to 113.4 mg/dL; p < 0.001), together with significant reductions in IL-6, PCT, and ferritin; IL-6 decreased by 71.7%, PCT by 79.7, and ferritin by 70.6% (all p < 0.001). Lactate levels decreased from 3.5 to 2.4 mmol/L (p < 0.001), and significant reductions were detected in AST, ALT, and LDH levels (p < 0.001). A decrease in VIS was observed between the pre-filter and 72 h (from 55 to 45; p = 0.034), and no procedure-related adverse events or hemodynamic instability were observed.

In our study, HA60 hemoadsorption was associated with reductions in inflammatory markers, improvements in organ function parameters, and a decrease in vasoactive inotropic scores in critically ill children with septic shock. These findings are preliminary; prospective controlled studies are needed to establish the efficacy and optimal use of HA60 in pediatric septic shock.