Effect of therapeutic plasma exchange on tissue factor and tissue factor pathway inhibitor in septic shock
Authors' conclusion
Adjunctive TPE in septic shock is associated with a significant removal of both TF and TFPI, which may contribute to the early hemodynamic improvement observed in septic shock patients receiving TPE.
Study context
- Population
- Patients with early (shock onset < 24 h) and severe (norepinephrine dose > 0.4 μg/kg/min) septic shock
- Participants
- 51 patients
- Comparison
- SOC + one single therapeutic plasma exchange (TPE) vs SOC
- SOCn = 14reference
- TPEn = 37
- Primary endpoint
- Effect of TPE on plasma concentrations of TF and TFPI
- Follow-up
- 6 h
Primary result
As reported in the abstract
Relative change of TF and TFPI within 6 h
- Relative change of tissue factor (TF), SOC: + 14 (−0.8 to + 30.4) % (p = 0.089)
- Relative change of TF, TPE: −18.3 (−32.6 to −2.2) % (p < 0.001); between group p < 0.001
- Relative change of tissue factor pathway inhibitor (TFPI), SOC: + 14.4 (−2.3 to + 30.9) % (p = 0.076)
- Relative change of TFPI, TPE: −20 (−32.8 to −7.9) % (p < 0.001); between group p = 0.022
- Ratio of TF to TFPI unchanged in both SOC and TPE
Further findings
Lactate over first 24 h by baseline TF and TFPI
- SOC: increase in lactate when baseline TF and TFPI higher
- TPE: sustained lactate reduction across all levels of baseline TF and TFPI
- Multivariate mixed-effects model, TPE: higher baseline TF led to greater lactate reduction (p = 0.003)
- Multivariate mixed-effects model, TPE: higher baseline TFPI led to greater lactate reduction (p = 0.053)
Original publication
Effect of therapeutic plasma exchange on tissue factor and tissue factor pathway inhibitor in septic shock. Crit Care. Published 30 October 2024. doi:10.
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