Multimodal LPS-Selective Hemoadsorption and Hemodiafiltration in the Intensive Care of Gram-Negative Sepsis Patients: a Multicenter Observational Study

Мультимодальная ЛПС-селективная гемоадсорбция и гемодиафильтрация в интенсивной терапии грамотрицательного сепсиса: многоцентровое обсервационное исследование
Ismailov E.L. Espenbetov Y.B. Askarbekov Z.S. Aryn K.N. Sharipov M.K. Serdaliev A.O. Ermagambetov K.K. Mirzakhanov P.T. Tungishbaev A.U. Auezbekov A.A. Shaikhutdinov D.F.
2025 V.A. Negovsky Research Institute of General Reanimatology

Obshchaya Reanimatologiya
2025 #21 Issue 6 4 - 12 pp.

The aim of the study. To evaluate the effectiveness of multimodal selective lipopolysaccharide (LPS) hemoadsorption in combination with renal replacement therapy (RRT) in patients with gram-negative sepsis or septic shock. Materials and methods. The study included 39 patients. In the main prospective group, patients received extracorporeal therapy in addition to standard of care (ET group, n=10). In the retrospective comparison group, patients received only standard therapy (ST group, n=29). Results. In the ET group, the average SOFA score decreased by 3.4 [95% CI: 0.8; 5.2] scores after 72 hours of treatment, while in the ST group, the average SOFA value increased by 1.7 [95% CI: 0; 3.4] scores over the same period, p_adj=0.002. Hospital mortality was 1/10 (10%) in the ET group and 19/29 (66%) in the ST group, and OR=0.06 [95% CI: 0.01; 0.4] p=0.003. The analysis, including consideration of severity of the condition at a baseline as a potential confounding factor, confirmed the robustness of the results: statistically significant differences in SOFA dynamics and mortality remained. Conclusion. The use of selective hemoadsorption in combination with renal replacement therapy reduces the severity of organ dysfunction and mortality in patients with sepsis or septic shock.

acute renal failure , endotoxins , hemoadsorption , renal replacement therapy , sepsis , septic shock

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S.D. Asfendiyarov Kazakh National Medical University, 94 Tole Bi Str., Almaty, 050012, Kazakhstan
Almaty City Clinical Hospital No, 7, 78 Aspandiyarova Str., Almaty, 050006, Kazakhstan
Aktobe Medical Center, 8E Zhanakonys Residential Complex, Aktobe, 030017, Kazakhstan
Shymkent City Hospital No. 2, 92 S. Zhandosov Str., Shymkent, 160060, Kazakhstan
Taraz City Multidisciplinary Hospital, 2B Al-Farabi Str., Taraz, 080009, Kazakhstan
Regional perinatal center, 59 Sultan Beybarys Str., Kyzylorda, 120016, Kazakhstan

S.D. Asfendiyarov Kazakh National Medical University
Almaty City Clinical Hospital No
Aktobe Medical Center
Shymkent City Hospital No. 2
Taraz City Multidisciplinary Hospital
Regional perinatal center

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