Filter life and safety of heparin‐grafted membrane for continuous renal replacement therapy ‐ A randomized controlled trial

Abstract

Acute kidney injury (AKI) is a major complication of critical illness. More than 70% of patients with oliguric AKI and marked azotemia receive renal replacement therapy (RRT). 1 Continuous renal replacement therapy (CRRT) is the preferred option worldwide in critical care, accounting for 80% of all modalities used. 2 However, prolonged extracorporeal circulation is associated with higher risk of filter clotting, which is worsened by the inflammatory and pro-coagulant state in critical illness. 3 Premature circuit terminations compromise the treatment efficacy of CRRT, 4 contribute to blood loss and transfusions in patients, 5 and increase nursing workload required for circuit priming. Critically ill patients also have higher bleeding risk, in whom systemic anticoagulation

The effect of the AN69 ST100 versus oXiris® membrane on filter life during CRRT for non-anticoagulated liver failure patients.

“…The results of our study, which focus on filter life, are comparable and in line with the study by Wong et al 17 who reported similar time(s) and no difference comparing oXiris ® and standard membranes in 20 septic and cardiogenic AKI patients. These comparative findings are also comparable to a clinical study conducted by Shum et al where circuit life using oXiris ® -to modulate sepsis was similar to that of historical controls.…”

Application of oXiris-continuous hemofiltration adsorption in patients with sepsis and septic shock: A single-centre experience in China

“…Other adverse events were mainly thrombosis-related adverse events, but no bleeding-related adverse events were seen. Studies have also shown that fixed heparin has no significant systemic anticoagulant or adverse bleeding events ( 55 ). This also suggests that we should regulate anticoagulation according to the condition of oXiris treatment to reduce activation of the coagulation system and the consumption of coagulation factors and platelets.…”

A Role of Circuit Clotting and Strategies to Prevent It during Blood Purification Therapy with oXiris Membrane: An Observational Multicenter Study

“…The preliminary observation made in this study certainly deserves further and deeper experimental insights. In a single-center, prospective, open-label, pilot randomized controlled study using a crossover design, Wong et al [9] failed to demonstrate that heparin coating alone can reduce membrane fouling in critically ill patients. In fact, treatment prescription and specific patients' characteristics may critically contribute to membrane fouling, independently from membrane biocompatibility.…”

“…The oXiris membrane (Baxter, Deerfield, IL, USA) is a biocompatible high-flux hemodiafilter combining diffusive and convective clearances, used to support renal function and to remove circulating cytokines and endotoxins [8]. More specifically, the heparin-coated layer of the oXiris membrane limits the activation of the coagulation cascade, which is often overly activated in patients with severe hyper inflammation (e.g., critically ill septic patients [9]).…”