Trial reportIntensive care medicine2021
High dose coupled plasma filtration and adsorption in septic shock patients. Results of the COMPACT-2: a multicentre, adaptive, randomised clinical trial.
Trial report in Intensive care medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed, 3 syntheses or guidelines pooled it, 78 citations in OpenAlex.
- [S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Guideline
- Influence of therapeutic plasma exchange treatment on short-term mortality of critically ill adult patients with sepsis-induced organ dysfunction: a systematic review and meta-analysis.Critical care (London, England) · 2024Pooled it
- Coupled plasma filtration adsorption for the treatment of sepsis or septic shock: a systematic review and meta-analysis.BMC infectious diseases · 2022Pooled it
- [Extracorporeal immunomodulation in sepsis : Role, limits, and perspectives of adjuvant blood purification therapies].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Review
- The NLRP3 inflammasome in physiological and dysfunctional host response in human sepsis and critical illness: a narrative review.Critical care (London, England) · 2026Review
- Early Immune Phenotype-Guided Immunomodulatory Strategies and Intensive Care Outcomes in Septic Shock: A Single-Center Retrospective Cohort Study.Shock (Augusta, Ga.) · 2026Observational
- Timing of hemoadsorption in sepsis: redefining early through mediator-guided therapy.Journal of intensive care · 2026Review
- The role of hemoadsorption in septic shock: toward a personalized approach.Critical care (London, England) · 2026Review
- Knowledge gaps in extracorporeal blood purification: what would be required for its successful application in septic shock?Intensive care medicine experimental · 2025Review
- Efficacy of Adaptive Blood Purification for Septic Shock (EABPSS): protocol for a randomised, multicentre, parallel controlled study.BMJ open · 2025Article
- Hemoadsorption in septic shock - CON.Intensive care medicine · 2025Article
- Haemoadsorption to remove inflammatory mediators in sepsis: past, present, and future.Intensive care medicine experimental · 2025Review
- Rethinking caution: a critical appraisal of extracorporeal blood purification in sepsis.Critical care (London, England) · 2025Article
- A few words of caution on blood purification in sepsis.Critical care (London, England) · 2025Article
- Use of extracorporeal blood purification therapies in sepsis: the current paradigm, available evidence, and future perspectives.Critical care (London, England) · 2024Review
- Macrophage activation syndrome in Sepsis: from pathogenesis to clinical management.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2024Review
- Plasma exchange in septic shock: are we ready for prime time? PRO.Intensive care medicine · 2024Article
- [Extracorporeal procedures in sepsis].Die Anaesthesiologie · 2024Review
- Focusing on the Basic Principles of Dialysis to Optimize Antibiotic Therapy during Renal Replacement Therapy in Critically Ill Patients.Antibiotics (Basel, Switzerland) · 2024Article
- Extracorporeal organ support for critically ill patients: Overcoming the past, achieving the maximum at present, and redefining the future.World journal of critical care medicine · 2024Article
Corrections and comments
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Authors and funding
16 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis study aimed at evaluating the efficacy and safety of high-dose (> 0.2 L/kg of treated plasma per day) coupled plasma filtration-adsorption (CPFA) in treating patients with septic shock.
methodsMulticentre, randomised, adaptive trial, performed in 12 Italian intensive care units (ICUs). Patients aged 14 or more, admitted to the ICU with septic shock, or had developed it during the stay were eligible. The final outcome was mortality at discharge from the last hospital at which the patient received care.
resultsBetween May 2015, and October 2017, 115 patients were randomised. The first interim analysis revealed a number of early deaths, prompting an unplanned analysis. Last hospital mortality was non-significantly higher in the CPFA (55.6%) than in the control group (46.2%, p = 0.35). The 90-day survival curves diverged in favour of the controls early after randomisation and remained separated afterwards (p = 0.100). An unplanned analysis showed higher mortality in CPFA compared to controls among patients without severe renal failure (p = 0.025); a dose-response relationship was observed between treated plasma volume and mortality (p = 0.010).
conclusionThe COMPACT-2 trial was stopped due to the possible harmful effect of CPFA in patients with septic shock. The harmful effect, if present, was particularly marked in the early phase of septic shock. Patients not requiring renal replacement therapy seemed most exposed to the possible harm, with evidence of a dose-response effect. Until the mechanisms behind these results are fully understood, the use of CPFA for the treatment of patients with septic shock is not recommended.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.