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VOLUME 21 , ISSUE 11 ( 2017 ) > List of Articles

RESEARCH ARTICLE

Treatment of acute kidney injury complicating septic shock with EMiC2 high-cutoff hemofilter: Case series

King-Chung Chan, Wing-Wa Yan, Hoi-Ping Shum, Tak Chan

Keywords : Acute kidney injury, high-cutoff hemofilter, septic shock

Citation Information : Chan K, Yan W, Shum H, Chan T. Treatment of acute kidney injury complicating septic shock with EMiC2 high-cutoff hemofilter: Case series. Indian J Crit Care Med 2017; 21 (11):751-757.

DOI: 10.4103/ijccm.IJCCM_338_17

License: CC BY-ND 3.0

Published Online: 01-11-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: Extracorporeal blood purification therapies have been proposed to improve outcomes of patients with severe sepsis, with or without accompanying acute kidney injury (AKI), by removal of excessive inflammatory mediators. Materials and Methods: We report our experience with EMiC2 high-cutoff continuous venovenous hemofiltration/hemodialysis (HCO-CVVH/HD) in seven patients with AKI complicating septic shock. Results: The median treatment duration was 71 h, and the procedure was well tolerated. Trough serum albumin level of 20 g/L was observed after 2 h of treatment and none of the patients required albumin supplement. The hospital mortality rate was 29%, which appeared more favorable than the predicted mortality of 60%–78% based on disease severity scores. Circulating levels of interleukin-6 (IL-6), IL-10, and tumor necrosis factor-alpha improved over time. Conclusion: This case series shows that HCO-CVVH/CVVHD using EMiC2 hemofilter may provide good cytokine modulation, when used along with good quality standard sepsis therapy. A further large-scale prospective randomized controlled trial is recommended.


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