Hemoadsorption with oXiris in sepsis: analysis of biomarkers and outcomes in a Colombian case series

David Ballesteros, Servicio de Nefrología, Hospital Universitario San José, Popayán; Departamento de Medicina Interna, Facultad de Medicina, Universidad del Cauca, Popayán; Colombia
Rosa Dueñas, Departamento de Patología, Grupo de Investigación en Inmunología y Enfermedades Infecciosas, Universidad del Cauca, Popayán, Colombia
Victoria Niño-Castaño, Departamento de Patología, Grupo de Investigación en Inmunología y Enfermedades Infecciosas, Universidad del Cauca, Popayán, Colombia
Daniel R. Santiago, Departamento de Medicina Interna, Universidad Nacional de Colombia, Bogotá, Colombia
Isabel Saravia, Área Médica Colombia y Latinoamérica Sur, Vantive, Bogotá, Colombia
Linda M. Ibatá-Bernal, Departamento de Epidemiología, EpiThinK Health Consulting, Bogotá, Colombia

Objective: This study evaluates the effect of hemoadsorption (HA) with oXiris® on inflammatory biomarkers and clinical outcomes in adults with bacterial or fungal sepsis treated in a Colombian intensive care unit. Materials and methods: We conducted a retrospective observational case series including 10 adults with sepsis or septic shock who received continuous renal replacement therapy (CRRT) using the oXiris® membrane in the setting of hemodynamic instability and acute kidney injury. Seven patients had microbiologically confirmed bacterial infections, two had fungemia due to Candida species, and one had no microbiologic isolate at CRRT initiation. We analyzed clinical and laboratory trajectories at baseline, 24, 48, and 72 h; cytokines were measured at baseline, 24, and 72 h. We performed a prespecified sensitivity analysis excluding the patient without microbiologic isolation. Results: In the overall cohort, in-hospital mortality was 40% (4/10; 95% confidence interval, 17-69%). Among patients with microbiologically confirmed bacterial sepsis, several physiologic measures improved over time, including mean arterial pressure, renal function, and acid–base status. In the two fungemia cases, clinical and cytokine trajectories were heterogeneous and did not show a consistent directional signal. Findings were unchanged in sensitivity analyses excluding the patient without microbiologic isolation. Conclusion: In this case series, oXiris®-based CRRT was associated with favorable short-term trajectories in selected patients with bacterial sepsis. In fungemia, biologic plausibility and clinical response are less certain and require cautious interpretation. Larger comparative studies are needed.

Keywords: Sepsis. Cytokines. Hemoadsorption. oXiris. Biomarkers.