Hybrid blood purification strategy in pediatric septic shock
KeywordsSeptic Shock Mean Arterial Pressure Pediatric Intensive Care Unit Continuous Renal Replacement Therapy Procalcitonin
Continuous renal replacement therapy
Extracorporeal blood purification technique
Mean arterial pressure
Extracorporeal blood purification techniques (EBTs) are emerging as beneficial interventions in the management of sepsis. Although the combination of different EBTs has also been suggested as a potentially effective approach in the early phases of sepsis [1, 2], no data are available for pediatric septic shock.
In this case, the benefits of CRRT in the management of fluid overload and metabolic abnormalities in children with septic shock were associated with the immune-modulatory effects of EBTs. HCO filters are characterized by large pore size (e.g., cutoff value of 70 kDa) with improved convective clearance of middle molecular weight molecules, such as cytokines . CCs have a large surface area that could also directly adsorb and clear inflammatory mediators . The combination of HCO-CRRT and CC might have a synergistic effect in this setting ; this association has not yet been explored in the treatment of pediatric septic shock. Further studies are needed to assess the feasibility as well as the optimal timing of initiation of such an approach in children suffering from septic shock.
No funding to declare.
Availability of data and materials
The datasets during and/or analyzed during the current study are available from the corresponding author on reasonable request.
All authors read and approved the final manuscript.
The authors declare that they have no competing interests.
Consent for publication
Consent for publication of clinical data was given by the child’s parent.
Ethics approval and consent to participate
Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.