Home > Journals > Minerva Anestesiologica > Past Issues > Articles online first > Minerva Anestesiologica 2017 Jun 12

CURRENT ISSUE
 

ARTICLE TOOLS

Reprints
Cite this article as

MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,623


eTOC

 

Minerva Anestesiologica 2017 Jun 12

DOI: 10.23736/S0375-9393.17.11946-2

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Blood purification with continuous venovenous hemofiltration in patients with sepsis or acute respiratory distress syndrome. A systematic review and meta-analysis of randomized evidence

Alessandro PUTZU 1 , Ming-Xing FANG 2, 3, Martina, BOSCOLO BERTO 1, Alessandro BELLETTI 2, Luca CABRINI 2, Tiziano CASSINA 1, Giovanni LANDONI 2, 4

1 Department of Cardiovascular Anesthesia and Intensive Care, Cardiocentro Ticino, Lugano, Switzerland; 2 Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy; 3 Department of Intensive Care Medicine, 3rd Hospital of HeBei Medical University, Shi Jiazhuang, China; 4 Vita-Salute San Raffaele University, Milan, Italy


PDF  SUPPLEMENTARY MATERIAL  


INTRODUCTION: Severe inflammatory conditions, as severe sepsis/septic shock and acute respiratory distress syndrome (ARDS), are related to high morbidity and mortality. We performed a meta-analysis of randomized trials to assess if blood purification with continuous venovenous hemofiltration (CVVH) reduces mortality in these settings.
EVIDENCE ACQUISITION: Online databases were searched for pertinent studies up to March 2017. We included randomized-controlled trials on the use of CVVH as blood purification technique in comparison to conventional therapy in adult patients with severe sepsis/septic shock or ARDS but no acute kidney injury needing renal replacement therapy.
EVIDENCE SYNTHESIS: Eleven studies and 679 patients were included in the analysis. Patients who received CVVH had significantly lower mortality compared to conventional therapy (96 of 351 [27.35%] patients in the CVVH group vs. 129 of 328 [39.33%] in the conventional therapy group, OR = 0.58 [95% CI, 0.42, 0.81], p = 0.002, I2 10%, Number Needed to Treat = 8) at longest follow-up available.
CONCLUSIONS: Overall, low-quality evidence indicates that blood purification with CVVH might be associated with a significant reduction in mortality when performed in patients with sepsis or ARDS. The evidence is still insufficient to support a definitive conclusion of benefit. Further high-quality randomized controlled trials, adequately powered for mortality, are needed to clarify the impact of CVVH on these conditions.


KEY WORDS: Sepsis - Septic shock - Acute respiratory distress syndrome - Mortality - Meta-analysis

top of page

Publication History

Cite this article as

Putzu A, Fang MX, Boscolo Berto M, Belletti A, Cabrini L, Cassina T, et al. Blood purification with continuous venovenous hemofiltration in patients with sepsis or acute respiratory distress syndrome. A systematic review and meta-analysis of randomized evidence. Minerva Anestesiol 2017 Jun 12. DOI: 10.23736/S0375-9393.17.11946-2

Corresponding author e-mail

alessandroputzu@ymail.com