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. 2021 Mar;47(3):352-354.
doi: 10.1007/s00134-020-06339-1. Epub 2021 Jan 20.

Adjuvant therapeutic plasma exchange in septic shock

Sascha David #  1   2 , Christian Bode #  3 , Christian Putensen  3 , Tobias Welte  4 , Klaus Stahl  5 ; EXCHANGE study group
Collaborators, Affiliations

Adjuvant therapeutic plasma exchange in septic shock

Sascha David et al. Intensive Care Med. 2021 Mar.
No abstract available

PubMed Disclaimer

Conflict of interest statement

SD has received fees from Baxter for expert advice and talks about plasma exchange in sepsis. SD has received support from Terumo to study plasma exchange in COVID-19, and by the German Research foundation (DA1209/4-3). SD, CB and KS have applied for support of a multicenter RCT from the German Research Foundation (DA1209/6-1). Otherwise, the authors have no conflict of interest related to the topic.

Figures

Fig. 1
Fig. 1
Primary and key secondary endpoints. Violin blots showing (A) absolute norepinephrine (NE) doses in standard of care (SOC) and the therapeutic plasma exchange (TPE) group at randomization (0) and after 6 h. Wilcoxon-test was used to compare the paired longitudinal values, SOC 0 vs 6 h, p = 0.16; and TPE 0 vs 6 h, p < 0.0001). Mann–Whitney test was used to compare between groups: SOC 0 h vs TPE 0 h, p = 0.63; SOC 6 h vs TPE 6 h, p = 0.004). B Mean arterial pressure (MAP)/NE ratio at 0 and 6 h in SOC and the TPE group. Wilcoxon-test was used to compare the paired longitudinal values, SOC 0 vs 6 h, p = 0.123; and TPE 0 vs 6 h, p < 0.0001). Mann–Whitney test for between-group comparison (SOC 0 h vs TPE 0 h, p = 0.57; SOC 6 h vs TPE 6 h, p = 0.005) C Mean sequential organ failure assessment (SOFA) score calculated over nine consecutive days in the SOC and TPE group. D Kaplan–Meier survival graph for individuals in the SOC and TPE arm showing no statistical significant difference (log-rank test 0.437)
See this image and copyright information in PMC

References

    1. Steinhagen F, Schmidt SV, Schewe JC, Peukert K, Klinman DM, Bode C. Immunotherapy in sepsis—brake or accelerate? Pharmacol Ther. 2020;208:107476. doi: 10.1016/j.pharmthera.2020.107476. - DOI - PubMed
    1. Knaup H, Stahl K, Schmidt BMW, Idowu TO, Busch M, Wiesner O, Welte T, Haller H, Kielstein JT, Hoeper MM, David S. Early therapeutic plasma exchange in septic shock: a prospective open-label nonrandomized pilot study focusing on safety, hemodynamics, vascular barrier function, and biologic markers. Crit Care. 2018;22:285. doi: 10.1186/s13054-018-2220-9. - DOI - PMC - PubMed
    1. Busund R, Koukline V, Utrobin U, Nedashkovsky E. Plasmapheresis in severe sepsis and septic shock: a prospective, randomised, controlled trial. Intensive Care Med. 2002;28:1434–1439. doi: 10.1007/s00134-002-1410-7. - DOI - PubMed
    1. Keith PD, Wells AH, Hodges J, Fast SH, Adams A, Scott LK. The therapeutic efficacy of adjunct therapeutic plasma exchange for septic shock with multiple organ failure: a single-center experience. Crit Care. 2020;24:518. doi: 10.1186/s13054-020-03241-6. - DOI - PMC - PubMed
    1. Rimmer E, Houston BL, Kumar A, Abou-Setta AM, Friesen C, Marshall JC, Rock G, Turgeon AF, Cook DJ, Houston DS, Zarychanski R. The efficacy and safety of plasma exchange in patients with sepsis and septic shock: a systematic review and meta-analysis. Crit Care. 2014;18:699. doi: 10.1186/s13054-014-0699-2. - DOI - PMC - PubMed