Effect of continuous hemodiafiltration using an AN69ST membrane in patients with sepsis

Tanaka, Akihito; Inaguma, Daijo; Nakamura, Tomoaki; Watanabe, Yu; Ito, Eri; Kamegai, Naoki; Shimogushi, Hiroya; Murata, Mitsunobu; Shinjo, Hibiki; Koike, Kiyomi; Otsuka, Yasuhiro; Takeda, Asami

doi:10.1186/s41100-017-0093-z

Cited by 12 publications

(24 citation statements)

References 20 publications

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“…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].…”

Section: Discussioncontrasting

confidence: 56%

“…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%

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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

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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.

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Section: Discussioncontrasting

confidence: 56%

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

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“…The AN69ST membrane has increased capacity for cytokine removal in vitro owing to its hydrogel structure that enables cytokine adsorption not only in the membrane surface, but also within the bulk layer [16][17][18][19]. However, only few clinical studies of AN69ST have been reported [20][21][22]. In addition, these studies investigated the clinical efficacy of the AN69ST membrane only in patients who underwent CRRT in the intensive care unit (ICU), and no study has investigated the clinical effect of the AN69ST membrane in patients with panperitonitis.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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Introduction: Sepsis is a systemic inflammatory response syndrome caused by infectious diseases, with cytokines possibly having an important role in the disease mechanism. Acrylonitrile-co-methallyl sulfonate surface-treated (AN-69ST) membrane is expected to improve the outcomes of patients with sepsis through cytokine adsorption. Objective: This study aimed to investigate the clinical effect of the AN-69ST membrane in comparison to standard continuous renal replacement therapy (CRRT) membranes for panperitonitis due to lower gastrointestinal perforation. Methods: Using the Diagnosis Procedure Combination database, we identified adult patients with sepsis due to panperitonitis receiving any CRRT. Propensity score matching was used to compare patients who received CRRT with the AN69ST membrane (AN69ST group) and those who received CRRT with other membranes (non-AN69ST group). The primary outcome measure was in-hospital mortality. Results: A total of 528 and 1,445 patients were included in the AN69ST group and in the non-AN69ST group, respectively. Propensity score matching resulted in 521 pairs. There was no significant difference in in-hospital mortality (32.1 vs. 35.5%; p = 0.265) and 30-day mortality (41.3 vs. 42.8%, p = 0.074) between the AN-69ST group and the non-AN69ST group. Conclusion: There is no significant difference in-hospital mortality between CRRT with the AN69ST membrane and CRRT with standard CRRT membranes for panperitonitis due to lower gastrointestinal perforation. These results indicate that the AN69ST membrane is not superior to the standard CRRT membrane.

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“…The efficacies of AN69ST membranes and other adsorbing membranes have been compared previously. 11,12 A retrospective observational study by Tanaka et al reported that CRRT with AN69ST membranes stabilized the vital signs of patients with severe sepsis or septic shock compared to CRRT using polymethyl methacrylate membranes. 11 However, no studies till date have compared the value of AN69ST membranes vs nonadsorbing membranes in terms of clinical outcomes.…”

Section: Resultsmentioning

confidence: 99%

“…11,12 A retrospective observational study by Tanaka et al reported that CRRT with AN69ST membranes stabilized the vital signs of patients with severe sepsis or septic shock compared to CRRT using polymethyl methacrylate membranes. 11 However, no studies till date have compared the value of AN69ST membranes vs nonadsorbing membranes in terms of clinical outcomes. Moreover, previous studies comparing AN69ST membranes with other adsorbing membranes included patients with sepsis as defined by 2001 International Sepsis Definitions Conference criteria.…”

Section: Resultsmentioning

confidence: 99%

Comparison of the circulatory effects of continuous renal replacement therapy using AN69ST and polysulfone membranes in septic shock patients: A retrospective observational study

2020

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The acrylonitrile‐co‐methallyl sulfonate surface‐treated (AN69ST) membrane is expected to improve hemodynamics in patients with sepsis through cytokine adsorption. However, the clinical literature on AN69ST membranes is very limited. We aimed to compare the circulatory effects of continuous renal replacement therapy (CRRT) between patients using the AN69ST membrane and polysulfone (PS) membrane (a nonadsorbing membrane). This retrospective observational study enrolled 38 patients with septic shock, as defined by Sepsis‐3 criteria, who required CRRT from April 2013 to March 2018. Those who died within 24 hours after CRRT initiation and received polymyxin B‐immobilized fiber column direct hemoperfusion, extracorporeal membrane oxygenation, and CRRT using other membranes were excluded. The primary outcome was the vasopressor dependency index during the 12 hours after CRRT initiation, which was calculated as (inotropic score)/(mean arterial pressure). Of 38 patients analyzed, 16 underwent CRRT with an AN69ST membrane and 22 with a PS membrane. The median patient age was 68 years, and the median Acute Physiology and Chronic Health Evaluation (APACHE) II score at intensive care unit admission was 29.5. The vasopressor dependency index decreased significantly during the 12 hours after CRRT initiation in both groups (AN69ST: from 0.50 ± 0.43 to 0.33 ± 0.27 [P < .05], PS: from 0.34 ± 0.30 to 0.21 ± 0.22 [P < .05]). The time course of the vasopressor dependency index during the 12 hours did not differ between the two groups (P = .11). The vasopressor dependency index decreased significantly after CRRT initiation in both groups. The time course of the vasopressor dependency index did not differ between the groups.

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Effect of continuous hemodiafiltration using an AN69ST membrane in patients with sepsis

Cited by 12 publications

References 20 publications

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

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

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

Comparison of the circulatory effects of continuous renal replacement therapy using AN69ST and polysulfone membranes in septic shock patients: A retrospective observational study

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