Hemofiltration for neuroprotection in acute ischemic stroke: a prospective, pilot study

Abstract

Background

Hemofiltration reduces blood levels of cytokines, glutamate and other substances that increase the risk of stroke‐associated neurodegeneration. This study aimed to assess the safety and efficacy of hemofiltration in acute ischemic stroke patients.

Methods

37 patients (mean age 56±16 years) who had an ischemic stroke within the previous 12 hours were randomized to receive hemofiltration for 36 hours (n=19) or standard treatment (n=18). The primary outcome of interest was the occurrence of adverse events during the 28 day period following the stroke symptom onset. The secondary outcome was to assess the efficacy of hemofiltration in acute ischemic stroke.

Results

Eighteen patients who received hemofiltration and 17 patients who received standard care completed the study. There were no cases of sepsis or infection at the hemofiltration cannula site, nor other hemofiltration‐related complications. There was one case of fatal hemorrhagic transformation in each of the 2 groups. We failed to find any favorable effects on NIHSS scores at 7 days. However, we observed 17 patients (94%) with systemic inflammatory response syndrome in the control group and only 13 (68%) in the hemofiltration group.

Conclusion

Hemofiltration appears to be safe in acute ischemic stroke patients, but we were unable to demonstrate its efficacy. However, for a definite conclusion on efficacy, a larger study with longer follow‐up is required.

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