Effect of continuous hemodiafiltration using an AN69ST membrane in patients with sepsis

Background: Sepsis is a systemic inflammatory response syndrome caused by infectious disease. Severe sepsis and septic shock are extremely serious conditions with poor prognoses. It is reported that cytokines are deeply involved in the disease mechanism. Continuous hemodiafiltration (CHDF) using a poly(methyl methacrylate) (PMMA) membrane is reported to adsorb various cytokines and improve the status of patients with sepsis. Recently, another cytokine-adsorbing hemofilter, acrylonitrile-co-methallyl sulfonate surface-treated (AN69ST) membrane, has become available for CHDF in patients with sepsis. However, the clinical efficacy of this membrane remains unclear. Therefore, in this study, we compared the efficacy of AN69ST and PMMA membranes. Methods: This retrospective study included patients with severe sepsis or septic shock who underwent CHDF for at least 24 h in the intensive care unit from January 2013 to August 2016. Results: This study included 49 patients who underwent CHDF, 32 using an AN69ST membrane and 17 using a PMMA membrane. In the AN69ST and PMMA groups, average age was 71.1 ± 11.4 years and 74.7 ± 9.4 years, respectively, and percentage of men was 71.9 and 88.2%, respectively. Severity of sepsis and vital signs were not significantly different between groups at the start of CHDF. In addition, 28-day mortality was not significantly different between groups (43.8 vs. 35.3%, P = 0.1625). However, heart rate in the AN69ST group decreased significantly early in the course of CHDF (6, 12, and 24 h, P < 0.05) compared with the PMMA group. Conclusions: AN69ST and PMMA membranes showed equivalent efficacy. Furthermore, CHDF using an AN69ST membrane may be effective for early stabilization of vital signs.