Effects of enhanced adsorption haemofiltration versus haemoadsorption in severe, refractory septic shock with high levels of endotoxemia: the ENDoX bicentric, randomized, controlled trial
Authors' conclusion
In a highly endotoxemic, severe, refractory septic shock population neither the Toraymyxin adsorber nor the oXiris membrane could show a reduction in circulating endotoxin or cytokine levels over standard of care.
Study context
- Population
- Severe, refractory septic shock with high endotoxemia (endotoxin activity ≥ 0.6, vasopressor dependency index ≥ 3, volume resuscitation ≥30 ml/kg/24 h, ≥ single organ failure), two Swiss ICUs437 screened
- Participants
- 30 participants
- Comparison
- Enhanced adsorption haemofiltration (oXiris) or haemoadsorption (Toraymyxin) vs standard of care
- Standard of caren = 10reference
- oXirisn = 10
- Toraymyxinn = 10
- Primary endpoint
- Difference in endotoxin activity at 72-h post-intervention vs baseline
- Follow-up
- 72 h
Methodological detailsmultiarm, bicentric, 1:1:1 randomisation
- Multiarm
- Bicentric
- 1:1:1 randomisation
Primary result
As reported in the abstract
Endotoxin reduction · 72 h post-intervention-start
P = 0.82
Further findings
| Outcome | P value |
|---|---|
| Reduction of inflammatory cytokine levels · 72 hoXiris, Toraymyxin vs Standard of care · no difference between groups | P = 0.58 |
| Vasopressor weaning · 72 hoXiris, Toraymyxin vs Standard of care · no difference between groups | P = 0.95 |
| Reversal of organ injury · 72 hoXiris, Toraymyxin vs Standard of care · no difference between groups | P = 0.22 |
Original publication
Effects of enhanced adsorption haemofiltration versus haemoadsorption in severe, refractory septic shock with high levels of endotoxemia: the ENDoX bicentric, randomized, controlled trial. Ann Intensive Care. Published 14 December 2023. doi:10.
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