Endotoxins and Cytokines Removal During Continuous Hemofiltration With oXiris™

Inclusion criteria

• Male or female aged ≥ 18 years old,
• "Early" septic shock (in the first 12 hours after Intensive Care Unit (ICU) admission or readmission in the ICU after surgery), with lactatemia > 2 mmol/L and norepinephrine needs > 0.2 µg/kg/min 2 hours after the end of the initial surgery (to ensure that a potential anesthesia effect as disappeared),
• Secondary to a community-acquired or a nosocomial peritonitis (secondary or tertiary but not primary peritonitis),
• AKI KDIGO ≥ stage 2 or another indication for renal replacement therapy, according to the clinician in charge (if baseline creatinine is unknown, KDIGO ≥ stage 2 can be defined by a serum creatinine ≥ 2-fold the normal creatinine for age, gender, and ethnicity).

Exclusion criteria

• Inability to obtain informed consent from the patient or next of kin,
• Actual participation in another interventional study,
• Contraindications to citrate,
• Allergy to heparin,
• Pregnant or breastfeeding woman,
• Neutropenia < 0.5 G/L resulting from chemotherapy or other iatrogenic causes
• Patient receiving immunosuppressive therapy, long-term corticosteroids, therapeutic antibodies, chemotherapy in the last 6 months (whatever the dose),
• Patient with innate or acquired immune deficiency (for example severe combined immunodeficiency, HIV or AIDS)
• Onco-hematological disease (lymphoma, leukemia, myeloma) treated within the last 5 years (but inclusion of a patient with solid cancer who did not receive chemotherapy during the past 6 months is possible),
• Patient with expected ICU length of stay < 48 hours,
• Patient for whom a limitation of active care was pronounced at the time of enrollment,
• Patient with no social security insurance, with restricted liberty, or under legal protection.