Abstract
The aim of the study . To evaluate the effectiveness of multimodal selective lipopolysaccharide (LPS) hemoadsorption in combination with renal replacement therapy (RRT) in patients with gram-negative sepsis or septic shock. Materials and methods. The study included 39 patients. In the main prospective group, patients received extracorporeal therapy in addition to standard of care (ET group, n = 10). In the retrospective comparison group, patients received only standard therapy (ST group, n = 29). Results . In the ET group, the average SOFA score decreased by 3.4 [95% CI: 0.8; 5.2] scores after 72 hours of treatment, while in the ST group, the average SOFA value increased by 1.7 [95% CI: 0; 3.4] scores over the same period, p adj = 0.002. Hospital mortality was 1/10 (10%) in the ET group and 19/29 (66%) in the ST group, and OR = 0.06 [95% CI: 0.01; 0.4] p = 0.003. The analysis, including consideration of severity of the condition at a baseline as a potential confounding factor, confirmed the robustness of the results: statistically significant differences in SOFA dynamics and mortality remained. Conclusion . The use of selective hemoadsorption in combination with renal replacement therapy reduces the severity of organ dysfunction and mortality in patients with sepsis or septic shock.