Friday October 20, 2006
High-volume hemofiltration as salvage therapy in severe hyperdynamic septic shock

There tend to be a continue interest in high-volume hemofiltration for sepsis and every now and then we see studies in respected journals. Overall, literature tends to favor high-volume hemofiltration as a salvage therapy in severe septic shock and if nothing is working, why not to use it as a last resort?

Recently one study of 20 patients published from Chile to evaluate the effect of short-term (12 hours) high-volume hemofiltration (HVHF) in reversing progressive refractory hypotension and hypoperfusion in patients with severe hyperdynamic septic shock unresponsive to traditional sepsis therapy.
11 of 20 patients were found to be "responders" with decrease in decreased norepinephrine dose, lactate levels and heart rates. Arterial pH improved significantly. Hospital mortality was 18% (2/11) in responders but remained high with 67% in 'non-responders' ! Interestingly only one single 12-h HVHF session was given.

Study concluded that a single session of HVHF may be use with benefit as salvage therapy in severe refractory hyperdynamic septic-shock patients.


Study to watch: IVOIRE (hIgh Volume in Intensive Care)



Reference:

High-volume hemofiltration as salvage therapy in severe hyperdynamic septic shock - Intensive Care Medicine - Volume 32, Number 5 / May, 2006