Apheresis in patients with sepsis: A multicenter retrospective study
To consider the effectiveness of apheresis, which is a supportive treatment method, in sepsis. A hundred and eleven adults with sepsis or septic shock were included in this retrospective study. The demographic characteristics of the patients, the focus and source of infection causing sepsis or septi...
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| Veröffentlicht in: | Transfusion and apheresis science 2021-10, Vol.60 (5), p.103239-103239, Article 103239 |
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| creator | Aydin, Kaniye Korkmaz, Serdal Erkurt, Mehmet Ali Sarici, Ahmet Ekinci, Omer Baysal, Nuran Ahu Berber, Ilhami Dogan, Ali Dal, Mehmet Sinan Giden, Asli Odabasi Ulas, Turgay Kuku, Irfan Ozatli, Duzgun Eser, Bulent Altuntas, Fevzi |
| description | To consider the effectiveness of apheresis, which is a supportive treatment method, in sepsis.
A hundred and eleven adults with sepsis or septic shock were included in this retrospective study. The demographic characteristics of the patients, the focus and source of infection causing sepsis or septic shock, characteristics of the pathogen, Acute Physiological and Chronic Health Assessment (APACHE) II score, routine laboratory values, which apheresis method was used, the characteristics of the replacement fluids used during the apheresis procedure, the number of apheresis procedures, complications related to the apheresis procedure, the follow-up time after the procedure, and mortality were recorded. The primary outcome was 28-day mortality.
Sixty-nine (62.2 %) of the patients were male. The mean age of the patients was 47.7 ± 18.6 years. The most common source of sepsis was hospital-acquired (79.3 %), the most common pathogen causing sepsis was gram-negative bacteria (41.4 %), and the most common infection site was the respiratory tract (58.7 %). The median APACHE II score was 19 (13−24). 92 (82.9 %) of the patients had septic shock. Theropeutic plasma exchange (TPE) was performed in 11.7 % of the patients and immunoabsorbtion IA in 88.3 %. The median number of sessions was 3 (3−5). No procedure-related fatal complication was observed in the study. While 28-day mortality was 61.3 % in all patients, when the mortality according to the apheresis procedures was examined, it was 11.3 % and 88.2 % in the patients who underwent TPE and IA, respectively. The most common cause of mortality was multiorgan failure.
Apheresis in sepsis can be considered as a salvage treatment. The indication for apheresis in sepsis is still at the level of patient-based individualized decision in line with the studies done so far, including our study. However, there is a need for a multicenter randomized controlled study with a large number of patients in order to give positive or negative recommendations about its effectiveness. |
| doi_str_mv | 10.1016/j.transci.2021.103239 |
| format | Article |
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A hundred and eleven adults with sepsis or septic shock were included in this retrospective study. The demographic characteristics of the patients, the focus and source of infection causing sepsis or septic shock, characteristics of the pathogen, Acute Physiological and Chronic Health Assessment (APACHE) II score, routine laboratory values, which apheresis method was used, the characteristics of the replacement fluids used during the apheresis procedure, the number of apheresis procedures, complications related to the apheresis procedure, the follow-up time after the procedure, and mortality were recorded. The primary outcome was 28-day mortality.
Sixty-nine (62.2 %) of the patients were male. The mean age of the patients was 47.7 ± 18.6 years. The most common source of sepsis was hospital-acquired (79.3 %), the most common pathogen causing sepsis was gram-negative bacteria (41.4 %), and the most common infection site was the respiratory tract (58.7 %). The median APACHE II score was 19 (13−24). 92 (82.9 %) of the patients had septic shock. Theropeutic plasma exchange (TPE) was performed in 11.7 % of the patients and immunoabsorbtion IA in 88.3 %. The median number of sessions was 3 (3−5). No procedure-related fatal complication was observed in the study. While 28-day mortality was 61.3 % in all patients, when the mortality according to the apheresis procedures was examined, it was 11.3 % and 88.2 % in the patients who underwent TPE and IA, respectively. The most common cause of mortality was multiorgan failure.
Apheresis in sepsis can be considered as a salvage treatment. The indication for apheresis in sepsis is still at the level of patient-based individualized decision in line with the studies done so far, including our study. However, there is a need for a multicenter randomized controlled study with a large number of patients in order to give positive or negative recommendations about its effectiveness.</description><identifier>ISSN: 1473-0502</identifier><identifier>EISSN: 1878-1683</identifier><identifier>DOI: 10.1016/j.transci.2021.103239</identifier><identifier>PMID: 34412948</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Aged ; APACHE ; Apheresis ; Blood Component Removal ; Female ; Humans ; Immunadsorption ; Male ; Middle Aged ; Mortality ; Multiorgan failure ; Plasma Exchange - methods ; Retrospective Studies ; Sepsis ; Sepsis - therapy ; Severity of Illness Index ; Shock, Septic - therapy ; Therapeutic plasma exchange ; Treatment Outcome</subject><ispartof>Transfusion and apheresis science, 2021-10, Vol.60 (5), p.103239-103239, Article 103239</ispartof><rights>2021 Elsevier Ltd</rights><rights>Copyright © 2021 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-e9ea764d471d51520dbe3c51284d7c0ec37a638e79ce1bc9f11302a294ca4eee3</citedby><cites>FETCH-LOGICAL-c365t-e9ea764d471d51520dbe3c51284d7c0ec37a638e79ce1bc9f11302a294ca4eee3</cites><orcidid>0000-0001-5538-3692</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1473050221002317$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34412948$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aydin, Kaniye</creatorcontrib><creatorcontrib>Korkmaz, Serdal</creatorcontrib><creatorcontrib>Erkurt, Mehmet Ali</creatorcontrib><creatorcontrib>Sarici, Ahmet</creatorcontrib><creatorcontrib>Ekinci, Omer</creatorcontrib><creatorcontrib>Baysal, Nuran Ahu</creatorcontrib><creatorcontrib>Berber, Ilhami</creatorcontrib><creatorcontrib>Dogan, Ali</creatorcontrib><creatorcontrib>Dal, Mehmet Sinan</creatorcontrib><creatorcontrib>Giden, Asli Odabasi</creatorcontrib><creatorcontrib>Ulas, Turgay</creatorcontrib><creatorcontrib>Kuku, Irfan</creatorcontrib><creatorcontrib>Ozatli, Duzgun</creatorcontrib><creatorcontrib>Eser, Bulent</creatorcontrib><creatorcontrib>Altuntas, Fevzi</creatorcontrib><title>Apheresis in patients with sepsis: A multicenter retrospective study</title><title>Transfusion and apheresis science</title><addtitle>Transfus Apher Sci</addtitle><description>To consider the effectiveness of apheresis, which is a supportive treatment method, in sepsis.
A hundred and eleven adults with sepsis or septic shock were included in this retrospective study. The demographic characteristics of the patients, the focus and source of infection causing sepsis or septic shock, characteristics of the pathogen, Acute Physiological and Chronic Health Assessment (APACHE) II score, routine laboratory values, which apheresis method was used, the characteristics of the replacement fluids used during the apheresis procedure, the number of apheresis procedures, complications related to the apheresis procedure, the follow-up time after the procedure, and mortality were recorded. The primary outcome was 28-day mortality.
Sixty-nine (62.2 %) of the patients were male. The mean age of the patients was 47.7 ± 18.6 years. The most common source of sepsis was hospital-acquired (79.3 %), the most common pathogen causing sepsis was gram-negative bacteria (41.4 %), and the most common infection site was the respiratory tract (58.7 %). The median APACHE II score was 19 (13−24). 92 (82.9 %) of the patients had septic shock. Theropeutic plasma exchange (TPE) was performed in 11.7 % of the patients and immunoabsorbtion IA in 88.3 %. The median number of sessions was 3 (3−5). No procedure-related fatal complication was observed in the study. While 28-day mortality was 61.3 % in all patients, when the mortality according to the apheresis procedures was examined, it was 11.3 % and 88.2 % in the patients who underwent TPE and IA, respectively. The most common cause of mortality was multiorgan failure.
Apheresis in sepsis can be considered as a salvage treatment. The indication for apheresis in sepsis is still at the level of patient-based individualized decision in line with the studies done so far, including our study. However, there is a need for a multicenter randomized controlled study with a large number of patients in order to give positive or negative recommendations about its effectiveness.</description><subject>Adult</subject><subject>Aged</subject><subject>APACHE</subject><subject>Apheresis</subject><subject>Blood Component Removal</subject><subject>Female</subject><subject>Humans</subject><subject>Immunadsorption</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multiorgan failure</subject><subject>Plasma Exchange - methods</subject><subject>Retrospective Studies</subject><subject>Sepsis</subject><subject>Sepsis - therapy</subject><subject>Severity of Illness Index</subject><subject>Shock, Septic - therapy</subject><subject>Therapeutic plasma exchange</subject><subject>Treatment Outcome</subject><issn>1473-0502</issn><issn>1878-1683</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1PwzAMhiMEYmPwE0A5cunIV5OWC5rGpzSJC5yjLPW0TG1XknRo_55MHVw52bJf-7UfhK4pmVJC5d1mGr1pg3VTRhhNNc54eYLGtFBFRmXBT1MuFM9ITtgIXYSwIYQqWspzNOJCUFaKYoweZ90aPAQXsGtxZ6KDNgb87eIaB-hS_R7PcNPX0dnUAY89RL8NHdjodoBD7Kv9JTpbmTrA1TFO0Ofz08f8NVu8v7zNZ4vMcpnHDEowSopKKFrlNGekWgK3OWWFqJQlYLkykhegSgt0acsVpZwwkw61RgAAn6DbYW_nt189hKgbFyzUtWlh2wfNcskFUzJXSZoPUpuODR5WuvOuMX6vKdEHgHqjjwD1AaAeAKa5m6NFv2yg-pv6JZYED4MA0qM7B16nFdBaqJxPTHS1df9Y_ADhvoTJ</recordid><startdate>202110</startdate><enddate>202110</enddate><creator>Aydin, Kaniye</creator><creator>Korkmaz, Serdal</creator><creator>Erkurt, Mehmet Ali</creator><creator>Sarici, Ahmet</creator><creator>Ekinci, Omer</creator><creator>Baysal, Nuran Ahu</creator><creator>Berber, Ilhami</creator><creator>Dogan, Ali</creator><creator>Dal, Mehmet Sinan</creator><creator>Giden, Asli Odabasi</creator><creator>Ulas, Turgay</creator><creator>Kuku, Irfan</creator><creator>Ozatli, Duzgun</creator><creator>Eser, Bulent</creator><creator>Altuntas, Fevzi</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5538-3692</orcidid></search><sort><creationdate>202110</creationdate><title>Apheresis in patients with sepsis: A multicenter retrospective study</title><author>Aydin, Kaniye ; 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A hundred and eleven adults with sepsis or septic shock were included in this retrospective study. The demographic characteristics of the patients, the focus and source of infection causing sepsis or septic shock, characteristics of the pathogen, Acute Physiological and Chronic Health Assessment (APACHE) II score, routine laboratory values, which apheresis method was used, the characteristics of the replacement fluids used during the apheresis procedure, the number of apheresis procedures, complications related to the apheresis procedure, the follow-up time after the procedure, and mortality were recorded. The primary outcome was 28-day mortality.
Sixty-nine (62.2 %) of the patients were male. The mean age of the patients was 47.7 ± 18.6 years. The most common source of sepsis was hospital-acquired (79.3 %), the most common pathogen causing sepsis was gram-negative bacteria (41.4 %), and the most common infection site was the respiratory tract (58.7 %). The median APACHE II score was 19 (13−24). 92 (82.9 %) of the patients had septic shock. Theropeutic plasma exchange (TPE) was performed in 11.7 % of the patients and immunoabsorbtion IA in 88.3 %. The median number of sessions was 3 (3−5). No procedure-related fatal complication was observed in the study. While 28-day mortality was 61.3 % in all patients, when the mortality according to the apheresis procedures was examined, it was 11.3 % and 88.2 % in the patients who underwent TPE and IA, respectively. The most common cause of mortality was multiorgan failure.
Apheresis in sepsis can be considered as a salvage treatment. The indication for apheresis in sepsis is still at the level of patient-based individualized decision in line with the studies done so far, including our study. However, there is a need for a multicenter randomized controlled study with a large number of patients in order to give positive or negative recommendations about its effectiveness.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>34412948</pmid><doi>10.1016/j.transci.2021.103239</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0001-5538-3692</orcidid></addata></record> |
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| ispartof | Transfusion and apheresis science, 2021-10, Vol.60 (5), p.103239-103239, Article 103239 |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Adult Aged APACHE Apheresis Blood Component Removal Female Humans Immunadsorption Male Middle Aged Mortality Multiorgan failure Plasma Exchange - methods Retrospective Studies Sepsis Sepsis - therapy Severity of Illness Index Shock, Septic - therapy Therapeutic plasma exchange Treatment Outcome |
| title | Apheresis in patients with sepsis: A multicenter retrospective study |
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