Continuous venovenous hemofiltration combined with hemoperfusion for toxic epidermal necrolysis: a retrospective cohort study

J Dermatolog Treat. 2017 Jun;28(4):353-359. doi: 10.1080/09546634.2016.1240326. Epub 2016 Oct 24.

Abstract

Aim: The current treatments of toxic epidermal necrolysis (TEN) are limited to the discontinuation of a suspect medication and supportive measures. We conducted a retrospective study to evaluate the efficacy of adding continuous venovenous hemofiltration (CVVH) and hemoperfusion (HP) to the conventional treatment for TEN.

Methods: TEN patients who were admitted to our center between January 2008 and May 2016 were considered as candidates. The included patients were divided into the CVVH&HP group (n = 34) and the conventional group (n = 34) according to their accepted therapies during hospital stay.

Results: The patients in the conventional group had a significantly reduced 28-day survival proportion compared with patients in the CVVH&HP group (73.5 versus 91.2%, p = .047). The adjusted results demonstrated that the conventional group had a significantly higher risk of 28-day mortality as well. Moreover, patients in the CVVH&HP group were associated with significantly shorter hospital stay, rash, fever, and antibiotic durations. However, the addition of CVVH&HP to conventional treatment did not significantly increase the in-hospital cost.

Conclusions: In conclusion, CVVH&HP might be a safe and effective adjuvant therapy for TEN. Further well-designed studies are warranted to obtain robust evidence.

Keywords: Stevens–Johnson syndrome; Toxic epidermal necrolysis; continuous venovenous hemofiltration; glucocorticoids; hemoperfusion.

MeSH terms

  • Adult
  • Female
  • Hemofiltration / methods*
  • Hemoperfusion / methods*
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Retrospective Studies
  • Stevens-Johnson Syndrome / mortality
  • Stevens-Johnson Syndrome / therapy*
  • Survival Rate