Effects of Coupled Plasma Filtration Adsorption on Septic Patients with Multiple Organ Dysfunction Syndrome

Aim: The aim of this study was to observe the effects of coupled plasma filtration adsorption (CPFA) on septic patients with multiple organ dysfunction syndrome (MODS).

Methods: A total of 14 patients were randomly divided into two groups, and, respectively, received 10 h of CPFA or high-volume hemofiltration (HVHF). The mean arterial pressure (MAP), electrolytes and acid-base balance, the sequential organ failure assessment (SOFA) score, and the acute physiology and chronic health evaluation II (APACHE II) score were analyzed. Serum levels of high-mobility group box-1 (HMGB-1) protein, tumor necrosis factor-α (TNF-α), and intercellular adhesion molecule-1 (ICAM-1) were also measured by enzyme-linked immunosorbent assay.

Results: After CPFA and HVHF, temporary reduction in blood urea nitrogen and serum creatinine, electrolytes and acid-base metabolism balance were well maintained. Both the SOFA and the APACHE II scores were markedly reduced after CPFA (p < 0.01), while only the SOFA score was significantly decreased after HVHF (p < 0.05). After 10-h treatment with CPFA, the MAP and oxygen index (PaO(2)/FiO(2)) were significantly higher than those at 0 h. Furthermore, the serum levels of HMGB-1, ICAM-1, and TNF-α decreased after 10 h of CPFA (p < 0.05), while the serum levels of HMGB-1 declined at 5 h of HVHF, but rebounded at 10 h, and the serum levels of TNF-α and ICAM-1 were no significant change after treatment with HVHF.

Conclusions: The study indicated that CPFA could be superior to HVHF in improving the clinical manifestations and eliminating inflammatory mediators, which had implications in the optimal treatment of septic patients with MODS.