Clinical Effect of the Acrylonitrile-Co-Methallyl Sulfonate Surface-Treated Membrane as a Cytokine Adsorption Therapy for Sepsis due to Acute Panperitonitis: A Retrospective Cohort Study

Hayashi, Kentarou; Sasabuchi, Yusuke; Matsui, Hiroki; Nakajima, Mikio; Ohbe, Hiroyuki; Ono, Katsushige; Yasunaga, Hideo

doi:10.1159/000504560

Cited by 8 publications

(13 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Contrary to the aforementioned studies that showed the superiority of the AN69-oXiris filter to the AN69-ST filter in patients with intra-abdominal sepsis or with G−bacterial infections, Hayashi et al [35] found that CRRT using the AN69-ST membrane was superior to CRRT using standard membranes in patients with pneumonia-associated sepsis in reducing in-hospital mortality. However, this effect was not observed in pan-peritonitis owing to a lower gastrointestinal perforation [36]. In our study, we observed a decrease in SOFA scores from 12.0 (9.0, 13.5) to 9.0 (7.0, 11.25) in the ST group after treatment, which is consistent with the findings of other studies that used the AN69-ST filter [37, 38].…”

Section: Discussion/conclusionsupporting

confidence: 92%

Comparison of the Clinical Effectiveness of AN69-oXiris versus AN69-ST Filter in Septic Patients: A Single-Centre Study

et al. 2021

View full text Add to dashboard Cite

Introduction: The clinical effectiveness of AN69-oXiris remains unclear. This study aimed to compare the effects of AN69-oXiris and AN69-ST filters on cytokine levels and clinical improvement in septic patients. Methods: This prospective observational study recruited septic patients who underwent blood purification in the First Affiliated Hospital of Soochow University between December 2019 and May 2020. Patients were assigned to an AN69-oXiris (oXiris) or AN69-ST (ST) group based on their preferred filter. Patients’ clinical data, cytokine levels, and prognostic indicators were analysed at baseline (T0), 24 h after treatment (T1), and at the end of the treatment (T2). Results: Forty-four patients participated in this study (22 patients in each group). Participants in both groups showed improvements in mean arterial pressure (MAP) values, oxygenation indices, and urinary output, and decreased vasoactive-inotropic scores (VISs), heart rates, lactic acid levels, and serum creatinine levels after blood purification. Reductions in cytokine levels were observed at T1 in both groups. Improvement the haemodynamic status was higher in the oXiris group than in the ST group at T2 (MAP: 79.0 [76.0, 85.0] vs. 77.0 [72.75, 79.25] mm Hg, p = 0.04; VISs: 9.10 [0.00, 16.69] vs. 19.05 [10.60, 26.33], p = 0.03, respectively). Patients in the oXiris group also had lower cytokine levels than those in the ST group at T1 (tumour necrosis factor-α: 24.55 [16.9, 30.15] vs. 30.15 [23.38, 34.13] pg/mL, p = 0.04; interleukin (IL)-6: 66.63 [46.21, 102.20] vs. 125.48 [79.73, 167.97] pg/mL, p = 0.01; IL-8: 53.59 [35.10, 66.01] vs. 63.60 [45.58, 83.37] pg/mL, p = 0.04; IL-10: 13.50 [10.35, 18.68] vs. 17.15 [13.80, 21.95] pg/mL, p = 0.04, respectively). There were no significant differences between the 2 groups regarding hospital mortality, intensive care unit length of stay (LOS), and hospital LOS. Conclusion: Blood purification using the AN69-oXiris or AN69-ST filter proved useful for septic patients, which was associated with reduced cytokine levels and improved clinical condition. Patients treated with AN69-oXiris had a more remarkable improvement in haemodynamic status and lower cytokine levels than those treated with AN69-ST filter, but there were no differences in clinical outcomes. Further investigations are needed to prove this finding.

show abstract

Section: Discussion/conclusionsupporting

confidence: 92%

Comparison of the Clinical Effectiveness of AN69-oXiris versus AN69-ST Filter in Septic Patients: A Single-Centre Study

et al. 2021

View full text Add to dashboard Cite

show abstract

“…However, the two latest studies disagree on the efficacy of AN69ST in sepsis. Hayashi et al reported that the AN69ST membrane was not superior to the standard CRRT membrane in the treatment of sepsis due to acute panperitonitis [ 41 ], while Nakamura et al suggested that AN69 had a strong adsorption capacity for high mobility group box 1 protein (HMGB1), a typical endogenous risk cytokine in sepsis [ 42 ]. What is more, anaphylactoid reaction during hemodiafiltration on AN69 membrane has been observed in both adults [ 43 ] and pediatrics [ 44 ].…”

Section: Adsorptive Bptsmentioning

confidence: 99%

Application of Adsorptive Blood Purification Techniques during Cardiopulmonary Bypass in Cardiac Surgery

Liu

Zhou

2022

Oxidative Medicine and Cellular Longevity

View full text Add to dashboard Cite

By reason of surgical demand, the majority of cardiovascular procedures still depend on the use of cardiopulmonary bypass (CPB). Due to the nonphysiological state of CPB, it can cause complex and unpredictable inflammatory response, which may lead to significant morbidity and mortality. Unfortunately, the pharmacological and mechanical strategies that currently exist do not offer significant advantages in controlling inflammatory response and improving patient outcomes. The best strategy to reduce inflammation in CPB is still uncertain. In recent years, adsorptive blood purification techniques (BPTs) have emerged, among which CytoSorb is the latest representative device. Currently, the primary application area of adsorptive BPTs is in the control and treatment of systemic hyperinflammatory states, such as refractory septic shock patients. However, the evidences on efficacy and safety of adsorptive BPTs application during CPB surgery are still inconclusive, so we summarize the relevant evidences here and suggest future potential research areas.

show abstract

“…Several aspects of this study that differ from those of previous studies which investigated the effect of the AN69ST membrane compared with the standard CRRT membrane [27][28][29][30]. Firstly, our previous study, which investigated the effect of the AN69ST membrane in patients with panperitonitis due to lower gastrointestinal perforation, did not show a signi cant difference in outcomes between the AN69ST membrane and standard CRRT membrane groups [30]. The characteristics of patients included in this Table 3 shows the interaction of the subgroups for representative variables associated with in-hospital mortality.…”

Section: Discussionmentioning

confidence: 65%

“…Therefore, the standard CRRT membrane has been widely replaced by the AN69ST membrane to absorb cytokines in critically ill patients in Japan, regardless of the cause of sepsis. However, only a few clinical studies [26][27][28][29][30] on the AN69ST membrane have been reported, and the clinical effectiveness of the AN69ST membrane is still unclear.…”

Section: Introductionmentioning

confidence: 99%

In-Hospital Mortality After Blood Purification With and Without Acrylonitrile-Co-Methallyl Sulfonate Surface-Treated Membrane for Pneumonia-Associated Sepsis: A Retrospective Cohort Study

Hayashi

Sasabuchi

Matsui

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background: Cytokine removal therapy is one of the available therapies for sepsis. Acrylonitrile-co-methallyl sulfonate surface-treated (AN69ST, sepXiris®) membrane has cytokine adsorption capacity and has been widely used for treating sepsis in Japan. The aim of this study was to compare the effects of continuous renal replacement therapy (CRRT) with AN69ST membrane and conventional CRRT for patients with pneumonia-associated sepsis.Methods: We conducted a retrospective cohort study using the Diagnosis Procedure Combination database, a nationwide inpatient database in Japan. We identified adult patients who were hospitalized due to pneumonia and received CRRT within 2 days of admission from September 2014 to March 2017. We included patients who received CRRT with AN69ST membrane within 2 days of admission in the treatment group (AN69ST group); those who received CRRT with other membranes within 2 days of admission were included in the control group (non-AN69ST group). Propensity score matching was used to compare in-hospital mortality between the two groups.Results: Eligible patients (n=2,393) were categorized into the AN69ST group (n=631) or the non-AN69ST group (n=1,762). The overall in-hospital mortality rate in pneumonia patients treated with CRRT was 38.9%. Propensity score matching created a matched cohort of 545 pairs of patients. The in-hospital mortality rate was significantly lower in the AN69ST group than in the non-AN69ST group (35.8 vs. 41.8%, p=0.046).Conclusion: Our data suggest that CRRT with the AN69ST membrane was associated with a significantly lower in-hospital mortality than CRRT with standard membranes among patients with pneumonia-associated sepsis.

show abstract

Clinical Effect of the Acrylonitrile-Co-Methallyl Sulfonate Surface-Treated Membrane as a Cytokine Adsorption Therapy for Sepsis due to Acute Panperitonitis: A Retrospective Cohort Study

Cited by 8 publications

References 29 publications

Comparison of the Clinical Effectiveness of AN69-oXiris versus AN69-ST Filter in Septic Patients: A Single-Centre Study

Comparison of the Clinical Effectiveness of AN69-oXiris versus AN69-ST Filter in Septic Patients: A Single-Centre Study

Application of Adsorptive Blood Purification Techniques during Cardiopulmonary Bypass in Cardiac Surgery

In-Hospital Mortality After Blood Purification With and Without Acrylonitrile-Co-Methallyl Sulfonate Surface-Treated Membrane for Pneumonia-Associated Sepsis: A Retrospective Cohort Study

Contact Info

Product

Resources

About