Evaluation of the Efficacy of Blood Purification in Abdominal Septic Shock: A Prospective Interventional Controlled Study

Author : Kalinin Evgenii, Sergey Masolitin, Denis Protsenko, Marat Magomedov, Daniil Losev

Abstract :Introduction: The choice of extracorporeal blood purification (BP) for septic shock (SS) remains an unresolved problem. Objective: To evaluate the effectiveness of various approaches to BP in SS. Materials and Methods: Group 1 (n=34): conservative therapy and continuous venovenous hemodiafiltration (CVVHDF) were performed for urgent indications. Group 2 (n=35): early isolated CVVHDF. Group 3 (n=32): early combined BP (selective plasmofiltration and CVVHDF). Comparative analysis of clinical and laboratory parameters. Results: Combined BP as part of intensive care: from the 1st to the 5-th day of therapy, reduces C-reactive protein (CRP) concentration from 218.6 to 139.8 mg/L (p=0.001; -36.9%), in group 2 (218.6 to 178.5 mg/l; p=0.014; -18.5%) and group 1 (212.4 to 187.5 mg/l; p=0.339; -11.3%); IL-6: 244.2 to 72.1 pg/ml (p=0.003; -70.6%), in group 2: 231.2 to 125.4 pg/ml (p=0.004; -46.2%) and group 1: 244.1 to 186.5 pg/ ml (p=0.032; -26.8%); TNF: 19.7 to 4.3 pg/ml (p=0.008; 69.8%), in group 2: 19.6 to 11.2 pg/ml (p=0.002; -37.1%) and group 1: 20.1 to 18.9 pg/ml (p=0.092; -4.1%); significantly reduces the severity of organ dysfunction (SOFA) by the 3-rd day of therapy (p=0.019), in group 2 by the 5-th day (p=0.016) and in group 3 by the 7-th day (p=0.031); reduces the length of stay in the ICU by 49% compared to group 1 (from 20.7 to 10.7 days, p=0.002); reduces the length of stay in the hospital by 22.9% compared to group 1 (from 26.4 to 20.7 days, p=0.011); survival in the group was 69.9%, compared to group 1 – 43.1% (p=0.023) and group 2 – 58.4% (p=0.273). Conclusions: Early combined BP significantly reduces the concentration of interleukins, markers of inflammation, the severity of organ dysfunction, reduces the length of stay in the ICU and hospital, and improves survival, compared to isolated BP both in the early and delayed periods

Keywords :Septic shock, blood purification, selective plasmafiltration.

Conference Name :international forum on trauma and critical care (IFTCC-25)

Conference Place Beijing, China

Conference Date 11th Nov 2025