Lipopolysaccharide Adsorption at Septic Shock (LASSO) – multicenter randomized clinical study
Study design: Patients with abdominal sepsis, complicated with septic shock, were randomly divided in two subgroups. Patients in intervention subgroup were subjected to first Efferon® LPS hemoperfusions in <12 hours since onset of septic shock and second Efferon® LPS hemoperfusion in 24 hours since start of the first one. Median duration of hemoperfusions were 5.5 hours. Patients in control group received standard of care treatment without extracorporeal removal of endotoxin or inflammatory mediators.
Study conclusions:
Efferon® LPS hemoperfusion yielded significant improvements of vital functions and survival rate in patients with septic shock.
- Hemodynamics: increase of mean arterial blood pressure accompanied with decreased requirements to vasopressor and inotropic drugs (starting in 24 hours);
shorter duration of septic shock among surviving patients (57 hours in Efferon® LPS vs 101 hours in control group);
septic shock successfully resolved in 68% patients in Efferon® LPS group vs 40% in control group.
- Respiratory function: shorter duration of invasive mechanical ventilation in surviving patients (2.6 days in Efferon® LPS vs 4.8 days in control group)
higher chance of successful weaning from invasive mechanical ventilation (57% in Efferon® LPS vs 29% in control group)
increase of PaO2/FiO2 oxygenation index (starting in 24 hours).
- Renal function: lower serum creatinine (starting in 72 hours);
shorter duration of renal replacement therapy.
- Multiple Organ Failure Syndrome: lower SOFA score in Efferon® LPS hemoperfusion group (starting in 24 hours)
- Inflammatory biomarkers: Efferon® LPS hemoperfusion decreased levels of abnormally elevated serum procalcitonin, C-reactive protein, interleukin-6, leukocytes and neutrophils count. 75% patients responded with decrease of endotoxin levels in blood.