Burns : journal of the International Society for Burn Injuries · 2026
Association between the duration of the first hemofilter after septic shock and septic shock resolution in severely burned patients receiving continuous blood purification.
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Tran Hung Dinh, Nguyen Lam Nhu, Nguyen An Hai, Thi Diu Tran Hien, Le Nguyet Tran Minh, Minh Do Trung, Ngo Hung Tuan
Аннотация
INTRODUCTION: Septic shock is a major cause of mortality in severe burn patients. Our objective was to evaluate the association between the duration of the first hemofilter following septic shock and recovery from septic shock in severely burned patients treated with continuous blood purification combined with adsorption.
METHODS: A prospective, quasi- experimental study at department of Intensive Care, Vietnam National Burn Hospital. The study consisted of 55 episodes of septic shock in 38 severe burn patients with total burn size ≥ 20% of total body surface area. Continuous blood purification using the oXiris hemofilter conducted within 6 h of septic shock (SS) diagnosis, and after raising systolic blood pressure to above 90 mmHg.
RESULTS: TNF-α and IL-6 concentrations decreased significantly over time after filtration, with mean hourly reductions of 0.33 pg/mL (SE = 0.16; p = 0.037) and 5.37 pg/mL (SE = 2.29; p = 0.019), respectively. After 24 h of continuous blood purification, plasma endotoxin levels decreased significantly compared with those at 6 h after continuous blood purification (47 (27.5-89.55) pg/mL vs. 68.3 (53.45-120.25) pg/mL, p = 0.003). The longer the duration of the first filtration session after septic shock, the higher the IL-6 concentration measured at 24 h after septic shock (r = 0.36, p = 0.008). Replacement of the first hemofilter at 12 h after initiation of blood purification increased the likelihood of septic shock resolution by 3.89-fold (p = 0.001). The predictive performance for shock resolution was moderate (AUC = 0.74, sensitivity: 75%, specificity: 73.68%).
CONCLUSION: The longer the duration of the first filtration session after septic shock, the higher the IL-6 concentration at 24 h. Multivariable analysis demonstrated that the pre-CVVHDF SOFA score, pre-CVVHDF plasma IL-6 concentration, and first hemofilter replacement within 12 h were independent factors associated with septic shock reversal.
METHODS: A prospective, quasi- experimental study at department of Intensive Care, Vietnam National Burn Hospital. The study consisted of 55 episodes of septic shock in 38 severe burn patients with total burn size ≥ 20% of total body surface area. Continuous blood purification using the oXiris hemofilter conducted within 6 h of septic shock (SS) diagnosis, and after raising systolic blood pressure to above 90 mmHg.
RESULTS: TNF-α and IL-6 concentrations decreased significantly over time after filtration, with mean hourly reductions of 0.33 pg/mL (SE = 0.16; p = 0.037) and 5.37 pg/mL (SE = 2.29; p = 0.019), respectively. After 24 h of continuous blood purification, plasma endotoxin levels decreased significantly compared with those at 6 h after continuous blood purification (47 (27.5-89.55) pg/mL vs. 68.3 (53.45-120.25) pg/mL, p = 0.003). The longer the duration of the first filtration session after septic shock, the higher the IL-6 concentration measured at 24 h after septic shock (r = 0.36, p = 0.008). Replacement of the first hemofilter at 12 h after initiation of blood purification increased the likelihood of septic shock resolution by 3.89-fold (p = 0.001). The predictive performance for shock resolution was moderate (AUC = 0.74, sensitivity: 75%, specificity: 73.68%).
CONCLUSION: The longer the duration of the first filtration session after septic shock, the higher the IL-6 concentration at 24 h. Multivariable analysis demonstrated that the pre-CVVHDF SOFA score, pre-CVVHDF plasma IL-6 concentration, and first hemofilter replacement within 12 h were independent factors associated with septic shock reversal.