The following is a summary of “Continuous renal replacement therapy with the adsorptive oXiris filter may be associated with the lower 28-day mortality in sepsis: a systematic review and meta-analysis” published in the July 2023 issue of Critical Care by Wang et al.
Researchers performed a retrospective study to explore the efficacy of OXiris, a novel CRRT filter with adsorption coating, in treating sepsis, addressing inflammatory mediators and endotoxins.
They collected 11 databases and searched for relevant studies. Evidence was assessed using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). Primary outcome was 28-day mortality. Secondary outcomes included 7-, 14-, and 90-day mortality, intensive care unit (ICU) and hospital length of stay, mortality rates, norepinephrine (NE) dose, interleukin-6 [(IL-6) and lactate levels, and Sequential Organ Failure Assessment (SOFA) score.
Result showed the significant reduction in meta-analysis of 14 studies (695 patients) in 28-day mortality (odds ratio [OR] 0.53, 95% CI 0.36–0.77, P= 0.001) and ICU stay (WMD −1.91, 95% CI −2.56 to −1.26, P< 0.001) with oXiris filter in sepsis. SOFA score, NE dose, IL-6 and lactate levels, and 7- and 14-day mortalities were lower. About 90-day mortality, ICU and hospital mortality, and length of hospital stay were comparable. The observational studies were intermediate to high while RCTs had unclear risk of bias and small sample size, resulting in low or very low certainty evidence.
Investigators concluded that OXiris filter treatment in sepsis patients may reduce mortality, lactate levels, SOFA score, NE dose, and ICU stay, but evidence quality remains uncertain.
Source: ccforum.biomedcentral.com/articles/10.1186/s13054-023-04555-x