2013
DOI: 10.1097/ccm.0b013e31828cf412
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Blood Purification and Mortality in Sepsis

Abstract: Objectives Although blood purification improves outcomes in animal studies of sepsis, results of clinical trials have been mixed. We conducted a systematic review and meta-analysis of randomized trials to determine the association between various blood purification techniques and all-cause mortality in humans with sepsis. Data Sources We searched for relevant studies in MEDLINE, EMBASE, and the Cochrane Library database from January 1966 until May 2012. Study Selection Inclusion required a diagnosis of sep… Show more

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Cited by 156 publications
(60 citation statements)
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References 48 publications
(89 reference statements)
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“…A 2013 meta-analysis of 16 trials concluded that blood purification decreased mortality in sepsis compared to no blood purification. However, these results were driven mainly by hemoperfusion and plasma exchange, and pooling of all trials of blood purification for treatment of sepsis was no longer associated with lower mortality after excluding trials using polymyxin B hemoperfusion [88]. There is also a negative study pending publication using polymyxin B hemoperfusion presented at ESICM LIVES 2016 [89].…”
Section: Determine the Efficacy Of "Blood Purification" Therapies Sucmentioning
confidence: 99%
“…A 2013 meta-analysis of 16 trials concluded that blood purification decreased mortality in sepsis compared to no blood purification. However, these results were driven mainly by hemoperfusion and plasma exchange, and pooling of all trials of blood purification for treatment of sepsis was no longer associated with lower mortality after excluding trials using polymyxin B hemoperfusion [88]. There is also a negative study pending publication using polymyxin B hemoperfusion presented at ESICM LIVES 2016 [89].…”
Section: Determine the Efficacy Of "Blood Purification" Therapies Sucmentioning
confidence: 99%
“…An extensive research of the literature identified 16 clinical trials, including those evaluating hemofiltration, hemoperfusion and plasma exchange techniques. Blood purification was able to reduce the mortality of septic patients, although this result was mainly driven by polymyxin B-based studies, thus confirming its relevant role in changing the course of septic disease [21]. …”
Section: Ongoing Trials and Future Directionsmentioning
confidence: 99%
“…These results are mainly influenced by studies using polymyxin B hemoperfusion from Japan [24]. Removing endotoxin would be an effective approach in the management of severe sepsis and in refractory septic shock.…”
Section: Therapeutic Strategiesmentioning
confidence: 99%
“…These devices have also been successfully used in patients with sepsis due to Gram-positive microorganisms and in patients with acute respiratory distress syndrome, suggesting that they could have an immunomodulating action in addition to endotoxin elimination [25,26,27]. The impact of blood purification on survival was not attenuated in subgroups with lower risk of death, indicating the need for future trials of early blood purification to prevent the progression of sepsis disease [24]. …”
Section: Therapeutic Strategiesmentioning
confidence: 99%