Clinical Efficacy of Blood Purification in the Treatment of Sepsis: a Meta-Analysis of the last 5 Years

BACKGROUND: Sepsis is the second leading cause of death in the intensive care unit (ICU) after coronary heart disease. Blood purification (BP) technology is a protocol for treating sepsis patients, but efficacy is controversial. Herein, we did a meta-analysis of the last 5 years of studies to investigate the clinical efficacy of blood purification in the treatment of sepsis. METHODS: We searched for studies of BP treatment of sepsis patients on PubMed, Embase, Medline, and Cochrane library. Two independent reviewers assessed included studies and met to develop consensus on included studies. We also used Review Manager 5.3 software to evaluate the risk of bias. RESULTS: The present meta-analysis included 13 randomized controlled trials (RCT) containing 1,230 sepsis patients. In the fixed-effect meta-analysis of 13 RCTs, BP treatment had a statistically significant efficacy on mortality (OR = 0.76, 95% CI = 0.6 - 0.97, p = 0.03) and ICU stay time (SMD = -3.42, 95% CI = -5.30 to -1.54, p < 0.001) reduction for patients with sepsis. Further subgroup analysis showed that none of high-volume hemofiltration (OR = 0.69, 95% CI = 0.42 - 1.12, p = 0.13), polymyxin B blood perfusion (OR = 0.92, 95% CI = 0.64 - 1.30, p = 0.62), and cytokine adsorption (OR = 0.66, 95% CI = 0.37 - 1.17, p = 0.15) significantly reduced mortality in sepsis patients. CONCLUSIONS: Adjuvant blood purification therapy can reduce mortality and shorten ICU stay for patients with sepsis, but the clinical efficacy of different blood purification techniques is inconsistent.