Acute Kidney Injury (AKI) is a common complication in burned patients affected by sepsis. Moreover, the AKI represents an important risk factor since it increases the mortality of the patients in the intensive care unit (ICU). The sepsis induces the release of inflammatory cytokines who may determine an acute renal failure aggravating the prognosis of the patient.
A consistent percentage of burn patients hospitalized in ICU may develop infections in the areas of burned skin and therefore they may undergo to blood infection and subsequently to AKI. The exacttiming for starting a dialytic therapy for those patients who become affected by blood infection and AKI remains disputed.
Materials and Methods
From January 2019 to January 2020, 11 burn patients affected by sepsis have been treated with Continuous Renal Replacement Therapy (CRRT) with Special Filters (SF) in the Burn Center of the “Sant’Eugenio” hospital in Rome. 5 patients were affected only by blood infection without AKI, while 6 patients experienced acute renal failure secondary to multiple etiology and sepsis.
The treatment proposed was the use of the new membranes (Septex and Oxiris special filter) for both groups (also in the patients suffering from sepsis alone since they showed an insufficient response to antibiotic therapy probably because the cytokine storm established a condition of systemic inflammatory response), and the patient selection was performed according to the guidelines of SEPSI and KDIQO.
Blood clotting prevention was achieved with calcium citrate (CiCa) in those cases treated with Oxirisfilter, while systemic anticoagulation with sodium heparin was performed when Septexfilter has been used.
SOFA score was recorded for each patient at the time of hospitalization.
The primary endpoint was the mortality at 30 days after hospitalization.
Results
7 patients were alive at 30 days after hospitalization, 4 of them treated with Oxiris filter and the remaining 3 patients treated with Septex filter. 4 of these patients were not affected by AKI.
Filtering efficiency in term of timing for depletion of filtration capacity was better with Oxiris than Septex: the half-life recorded was 44 hours for Oxiris and 24 hours for Septex. Moreover, the efficacy of the CiCa in the prophylaxis of clotting during hemodialysis with Oxiris filter was shown to be higher than that with systemic sodium heparin administered with Septex filter.
Conclusion
Burn patients affected by sepsis without AKI who have been treated with CRRT have shown a better 30-day survival in comparison with those patients who were also affected by AKI. A better filtering efficiency was detected with Oxiris than Septex filters. Moreover, according to our experience and based solely on nephrological criteria, an early start (within the first 12 hours after admission) of renal replacement therapy may improve the outcome of both groups, either the one made up by patients with only sepsis or the other in which an acute renal failure was recorded.

Acute Kidney Injury (AKI) is a common complication in burned patients affected by sepsis. Moreover, the AKI represents an important risk factor since it increases the mortality of the patients in the intensive care unit (ICU). The sepsis induces the release of inflammatory cytokines who may determine an acute renal failure aggravating the prognosis of the patient.
A consistent percentage of burn patients hospitalized in ICU may develop infections in the areas of burned skin and therefore they may undergo to blood infection and subsequently to AKI. The exacttiming for starting a dialytic therapy for those patients who become affected by blood infection and AKI remains disputed.
**Materials and Methods**
From January 2019 to January 2020, 11 burn patients affected by sepsis have been treated with Continuous Renal Replacement Therapy (CRRT) with Special Filters (SF) in the Burn Center of the “Sant’Eugenio” hospital in Rome. 5 patients were affected only by blood infection without AKI, while 6 patients experienced acute renal failure secondary to multiple etiology and sepsis.
The treatment proposed was the use of the new membranes (Septex and Oxiris special filter) for both groups (also in the patients suffering from sepsis alone since they showed an insufficient response to antibiotic therapy probably because the cytokine storm established a condition of systemic inflammatory response), and the patient selection was performed according to the guidelines of SEPSI and KDIQO.
Blood clotting prevention was achieved with calcium citrate (CiCa) in those cases treated with Oxirisfilter, while systemic anticoagulation with sodium heparin was performed when Septexfilter has been used.
SOFA score was recorded for each patient at the time of hospitalization.
The primary endpoint was the mortality at 30 days after hospitalization.
**Results**
7 patients were alive at 30 days after hospitalization, 4 of them treated with Oxiris filter and the remaining 3 patients treated with Septex filter. 4 of these patients were not affected by AKI.
Filtering efficiency in term of timing for depletion of filtration capacity was better with Oxiris than Septex: the half-life recorded was 44 hours for Oxiris and 24 hours for Septex. Moreover, the efficacy of the CiCa in the prophylaxis of clotting during hemodialysis with Oxiris filter was shown to be higher than that with systemic sodium heparin administered with Septex filter.
**Conclusion**
Burn patients affected by sepsis without AKI who have been treated with CRRT have shown a better 30-day survival in comparison with those patients who were also affected by AKI. A better filtering efficiency was detected with Oxiris than Septex filters. Moreover, according to our experience and based solely on nephrological criteria, an early start (within the first 12 hours after admission) of renal replacement therapy may improve the outcome of both groups, either the one made up by patients with only sepsis or the other in which an acute renal failure was recorded.

P.047 Use of the new filtration membranes for sepsis: a valid opportunity in burn patients admitted in intensive care unit. Experience from our burn center

Dear friends and colleagues,

We will be pleased to welcome you in Turin (Italy) for the 19th European Burns Association´s Congress in 2022. Italy is honored to hold the meeting of the European Burns Association for the second time, after Verona in 1995. Turin is easily reachable from everywhere in Europe, either travelling by car, train or choosing flight connections. During the meeting, held in the renewed industrial center of the main Italian historical automotive factory (i.e. Lingotto-FIAT), we will meet international burn specialists, focusing on standards of care, progresses in burn treatment, strategies to face disaster situations, with a special attention to education of younger colleagues. However, in your spare time, you might enjoy the sweet days of Italian late summer, simply wandering in the green parks and gardens along the two rivers which cross the city, or you might decide to discover the numerous art galleries, churches, palaces, libraries, walking across elegant squares and large boulevards, passing through centuries of art and history; finally, you may choose to immerse yourself in some of the most exciting museum experiences, such as the Cinema Museum and the Turin’s Egyptian museum.

Looking forward to seeing you all in Turin for the 19th European Association´s Congress in 2022!
Maurizio Stella, Congress President, Turin Burn Centre