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A Multiple Centre, Cohort Study of New CRRT Membranes oXiris for Patients With Septic Shock

Completed
Conditions
Acute Kidney Injury Due to Sepsis (Disorder)
Interventions
Device: Continuous renal replacement therapy with oXiris
Registration Number
NCT04073771
Lead Sponsor
Southeast University, China
Brief Summary

The objectives of this study are to determine whether Continuous Renal Replacement Therapy (CRRT) with oXiris in patients with septic shock would improve clinical outcomes such as the sepsis-related organ failure assessment (SOFA) , hemodynamic, mortality compared CRRT with conventional membrane.

Detailed Description

Sepsis is the leading cause of death in ICU, resulting in multi-organ failure in critically ill patients. Patients with septic shock combined sepsis-associated Acute kidney injury (AKI)have even poorer outcome.

Endotoxin activity, inflammation and immune dysfunction, have been consider relevant to their pathogenesis of sepsis. High levels of Inflammation are associated with worse clinical outcomes. However, all studies of anti-inflammation treatment in sepsis patient are failed and anti-inflammation treatment of sepsis still remains controversial.

oXiris is a new filter with adsorptive membrane, which removes endotoxin and inflammatory mediator from plasma. But current evidence of oXiris is limited, and only some small sample studies have proved that it can improve the haemodynamics and the sepsis-related organ failure assessment(SOFA) score.

Our hypothesis was that oXiris would be associated with better clinical outcomes, such as decreased SOFA score, improved survival rate, better hemodynamic, and improved of organ function.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
590
Inclusion Criteria
  • >18 Years
  • Treated by CRRT using oXiris or conventional membrane
  • SOFA cardiovascular Score ≥ 3
  • Septic shock due to abdominal or pneumonia( Gram-negative bacterial infection or suspected GNB infection)
  • Written informed consent
Exclusion Criteria
  • Chronic Kidney Disease
  • Renal replacement therapy (RRT) in the last 30 days
  • Pregnancy
  • Immunosuppressive treatment or steroids (prednisone > 0.5 mg/kg/day or equivalent).
  • Autoimmune disorder.
  • Transplant receptor.
  • Inclusion in other ongoing studies within the last 30 days.
  • Coexisting illness with a high probability of death

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Cohort studyContinuous renal replacement therapy with oXirisPatients with septic shock undergoing continuous renal replacement therapy
Primary Outcome Measures
NameTimeMethod
28-day mortality28 days

28-day mortality

The Sepsis-related Organ Failure Assessment(SOFA) cardiovascular Scores at 72 hours72 hours after Continuous Renal Replacement Therapy initiation

The Sepsis-related Organ Failure Assessment(SOFA) cardiovascular Scores at 72 hours(Scores Range 0-4, higher values represent a worse outcome)

Secondary Outcome Measures
NameTimeMethod
Changes of Sepsis-related Organ Failure Assessment(SOFA) Score72 hours after Continuous Renal Replacement Therapy initiation

Changes from baseline to 72 hours in Sepsis-related Organ Failure Assessment(SOFA) Score

Total length of Continuous Renal Replacement TherapyDay 28

Total length of Continuous Renal Replacement Therapy to day 28

mechanical ventilation free daysDay 28

Total length of mechanical ventilation free days up to to day 28

VIS-Norepinephrine dose or equivalent72 hours after Continuous Renal Replacement Therapy initiation

Norepinephrine dose or equivalent at 72 hours after Continuous Renal Replacement Therapy initiation

Lactate concentration at 72 hours72 hours after Continuous Renal Replacement Therapy initiation

Lactate concentration level at 72 hours after Continuous Renal Replacement Therapy initiation initiation

Change of Norepinephrine dose Over Time72 hours after Continuous Renal Replacement Therapy initiation

Difference of Norepinephrine dose at 72 hours compared with Continuous Renal Replacement Therapy initiation

Vasopressor-free daysDay 28

Vasopressor-free days to day 28

ICU mortalitythrough study completion, an average of 1 month

All cause mortality in ICU

Trial Locations

Locations (2)

Zhongda Hospital, Southeast University

🇨🇳

Nanjing, Jiangsu, China

Department of Nephrology, Sichuan University West ChinaHospital

🇨🇳

Chengdu, Sichuan, China

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