Multimodal LPS-Selective Hemoadsorption and Hemodiafiltration in the Intensive Care of Gram-Negative Sepsis Patients: a Multicenter Observational Study

The aim of the study. To evaluate the effectiveness of multimodal selective lipopolysaccharide (LPS) hemoadsorption in combination with renal replacement therapy (RRT) in patients with gram-negative sepsis or septic shock.
Materials and methods. The study included 39 patients. In the main prospective group, patients received extracorporeal therapy in addition to standard of care (ET group, n = 10). In the retrospective comparison group, patients received only standard therapy (ST group, n = 29).
Results. In the ET group, the average SOFA score decreased by 3.4 [95% CI: 0.8; 5.2] scores after 72 hours of treatment, while in the ST group, the average SOFA value increased by 1.7 [95% CI: 0; 3.4] scores over the same period, p_adj = 0.002. Hospital mortality was 1/10 (10%) in the ET group and 19/29 (66%) in the ST group, and OR = 0.06 [95% CI: 0.01; 0.4] p = 0.003. The analysis, including consideration of severity of the condition at a baseline as a potential confounding factor, confirmed the robustness of the results: statistically significant differences in SOFA dynamics and mortality remained.
Conclusion. The use of selective hemoadsorption in combination with renal replacement therapy reduces the severity of organ dysfunction and mortality in patients with sepsis or septic shock.

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