Effect of hemoperfusion on clinical efficacy and prognosis in patients with abdominal septic shock

Objective To explore the effect of hemoperfusion on clinical efficacy and prognosis in patients with septic shock caused by abdominal infection. Methods Sixty-three hospitalized patients with septic shock caused by abdominal infection transferred from Department of Gastrointestinal Surgery to Intensive Care Unit (ICU) of Zhongnan Hospital of Wuhan University from June 2018 to November 2018 were enrolled and divided into two groups. Patients of treatment group (n=28) were treated with hemoperfusion therapy in addition to conventional therapy, while patients of control group (n=35) only received conventional therapy. Clinical data including APACHEⅡ score, SOFA score, the demand for norepinephrine to achieve a certain mean arterial pressure (NOR/MAP), blood lactate level, procalcitonin (PCT), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were measured at different time points in each group during the treatment. The duration of ICU stay and 28-day mortality were compared between the two groups. Results There was no significant difference in basic condition (including a variety of clinical factors, such as age, gender, APACHEⅡ score, SOFA score and pathogenic bacteria composition, etc.) among all included patients (P>0.05). At 36 h after the initiation of treatment, the APACHEⅡ score, SOFA score, NOR/MAP, blood lactate, PCT, IL-6 and TNF-α levels decreased significantly in both groups (t=5.269, 2.715, 3.058, 1.937, 4.411, 3.163, 3.761, 2.553, 2.817, 2.473, 4.871, 5.066, 3.994, 2.532, P 0.05). Conclusion Hemoperfusion can improve APACHEⅡ score and hemodynamics, reduce the levels of PCT, IL-6 and TNF-α, shorten the duration of ICU stay, but has no effect on 28-day mortality in patients with septic shock caused by abdominal infection. Key words: Hemoperfusion; Sepsis; Abdominal infection; Septic shock; Inflammation mediator; Hemodynamics