Successful Extracorporeal Blood Purification Therapy Using Double Haemoadsorption Device in Severe Endotoxin Septic Shock: A Case Report
Article Category: Case Report
Data publikacji: 12 lis 2022
Zakres stron: 292 - 295
Otrzymano: 25 lut 2022
Przyjęty: 25 paź 2022
DOI: https://doi.org/10.2478/jccm-2022-0028
Słowa kluczowe
© 2022 Stefano Ferraro, Stefania Bianzina, Sonila Mocka, Francesca Cappadona, Giovanni Battista Traverso, Fabio Massarino, Pasquale Esposito published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Introduction
In patients admitted to the Intensive Care Unit (ICU), sepsis can lead to acute kidney injury (AKI), which may require the initiation of continuous renal replacement therapy (CRRT) in 15-20% of cases. There is no consensus about the best extracorporeal treatment to choose in septic patients with AKI.
Case presentation
We describe the case of a 70-year-old woman admitted to the ICU with a severe endotoxin septic shock due to Neisseria meningitidis serogroup C. Despite prompt medical intervention, including fluid resuscitation, high dose vasopressor, inotrope support, and broad-spectrum antimicrobial treatment, in a few hours patient’s haemodynamic worsened and she developed multi-organ failure, including severe AKI, requiring CRRT. So, continuous veno-venous haemodiafiltration was started, using an oXiris® haemodiafilter set, in series with an adsorber device (CytoSorb®). After 48 hours of this combined extracorporeal treatment, haemodynamic parameters improved, allowing a significant reduction of the vasoactive therapy, with a concomitant decrease in endotoxin and inflammatory markers serum levels. In the following days patient’s conditions still improved and renal function recovered.
Conclusions
Timely extracorporeal blood purification therapy, using a double haemoadsorption device, may be effective in the management of severe septic shock.