Blood Purification for Adult Patients With Severe Infection or Sepsis/Septic Shock: A Network Meta-Analysis of Randomized Controlled Trials
Authors' conclusion
Our NMA suggests that plasma exchange and polymyxin-B hemoperfusion may provide potential benefits for adult patients with severe infection or sepsis/septic shock when compared with standard care alone, but most comparisons were based on low or very low certainty evidence.
Study context
- Population
- Adults with severe infection or sepsis/septic shock
- Participants
- 4,595 adults · 60 randomized controlled trials (RCTs)
- Comparison
- 16 blood purification modalities vs standard care
- Outcome
- Overall mortality
Methodological detailsno language restrictions
- No language restrictions
Pooled result
As reported in the abstract
Each group vs standard careRelative risk (95% CI)
Polymyxin-B hemoperfusionvery low certainty of evidence; inconclusive due to high clinical heterogeneity and intransitivity
0.70(0.57–0.86)
Plasma exchangelow certainty of evidence
0.61(0.42–0.91)
Further pooled results
ICU LOS
- HA330 with high-volume CVVH, HA330 and standard-volume CVVH associated with shorter ICU stay
- Limited by scarcity of available studies
Mechanical ventilation days
- HA330 with high-volume CVVH, HA330 and standard-volume CVVH beneficial in reducing mechanical ventilation (MV) days
Acute kidney injury (AKI) incidence and kidney replacement therapy requirement
- No intervention showed a significant reduction
Original publication
Blood Purification for Adult Patients With Severe Infection or Sepsis/Septic Shock: A Network Meta-Analysis of Randomized Controlled Trials. Crit Care Med. Published 20 July 2023. doi:10.
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