Impact of HA60 hemoperfusion on inflammatory markers and organ function in critically ill children with septic shock.

OBJECTIVE

In this study, the efficacy and safety of HA60 hemoadsorption in pediatric sepsis/septic shock and multiple organ dysfunction were evaluated.

METHODS

Eight patients who underwent HA60 hemoperfusion were analyzed. In addition to standard sepsis treatment, all patients received a single 6-h session with the HA60 filter. Along with the vasoactive inotropic score (VIS), CRP, IL-6, PCT, ferritin, lactate, AST, ALT, LDH, and bilirubin levels were evaluated at 0, 24, 48, and 72 h.

RESULTS

The median age was 44.5 months, and 62.5% of the patients were male; 75% had underlying heart disease, all patients received invasive mechanical ventilation and CRRT, and 62.5% required ECMO. Following HA60, a significant decrease in CRP was observed up to 72 h (from 224.7 to 113.4 mg/dL; p < 0.001), together with significant reductions in IL-6, PCT, and ferritin; IL-6 decreased by 71.7%, PCT by 79.7, and ferritin by 70.6% (all p < 0.001). Lactate levels decreased from 3.5 to 2.4 mmol/L (p < 0.001), and significant reductions were detected in AST, ALT, and LDH levels (p < 0.001). A decrease in VIS was observed between the pre-filter and 72 h (from 55 to 45; p = 0.034), and no procedure-related adverse events or hemodynamic instability were observed.

CONCLUSION

In our study, HA60 hemoadsorption was associated with reductions in inflammatory markers, improvements in organ function parameters, and a decrease in vasoactive inotropic scores in critically ill children with septic shock. These findings are preliminary; prospective controlled studies are needed to establish the efficacy and optimal use of HA60 in pediatric septic shock.