The clinical usefulness of CHDF with AN69ST membrane in the treatment of patients with severe sepsis or septic shock

Abstract

We retrospectively investigated the clinical usefulness of continuous hemodiafiltration (CHDF) with AN69ST membrane in the treatment of patients with severe sepsis or septic shock. The subjects of this study were 28 consecutive patients with severe sepsis or septic shock who underwent CHDF for at least 24 hours during the period between January 2013 and October 2014. We divided the subjects into two groups : 11 subjects undergoing CHDF with AN69ST membrane (AN69ST membrane group) and 17 subjects undergoing CHDF with polymethylmethacrylate (PMMA) membrane (PMMA membrane group). Clinical parameters including blood pressure levels and the catecholamine index for 72 hours after the start of treatment were compared between these two groups. At the time of starting treatment with CHDF, the sequential organ failure assessment (SOFA) scores and levels of AST, ALT, LDH, total bilirubin, and CRP were significantly higher in the AN69ST membrane group than in the PMMA membrane group. A significant decrease in the catecholamine index was observed after treatment in both groups. Although there were no significant differences in blood pressure levels, changes in blood pressure, and the catecholamine index between the two groups, urine volume per unit time at the end of treatment was significantly greater in the AN69ST membrane group than in the PMMA membrane group. In addition, the duration of treatment with CHDF was significantly lower in the AN69ST group than in the PMMA membrane group. Although this study was retrospective, the results suggest that the effect of CHDF with AN69ST membrane was equivalent to or better than that of CHDF with PMMA membrane in patients with severe sepsis or septic shock.