Seraph® filter effectiveness in the treatment of circuit-related infections in ECMO patients—a single-center report

Introduction Nosocomial infections in patients undergoing extracorporeal membrane oxygenation (ECMO) are common and associated with poorer outcomes. This study aimed to analyze the efficacy of the Seraph filter in reducing circuit-related infections and improving clinical outcomes in COVID-19 patients treated with ECMO. Methods In 13 patients who required ECMO support, circuit-related infections were diagnosed based on either local signs of infection accompanied by positive microbiological samples taken locally or positive blood cultures. Hemoadsorption was performed using Seraph 100 in series with the dialyzer for 4–6 h. Blood cultures were also sampled both before and 24 h after treatment with Seraph 100. Results Sterile blood cultures were achieved in 53.8% of all patients. Blood cultures were found to be sterile from fungi ( Candida parapsilosis/glabrata ) and Stenotrophomonas malthophilia in all patients. In addition, the blood cultures were sterile from Klebsiella pneumoniae in 60%, Staphylococcus epidermidis in 75%, and Acinetobacter baumanii in 50% of all patients. We observed a significant reduction in vasopressor doses, an improvement in respiratory parameters, and a significant decrease in the sequential organ failure assessment (SOFA) score on the first day after treatment with Seraph 100. Conclusion This is the first study on ECMO patients treated with Seraph 100 for circuit-related infections. It shows a significant percentage of negative blood cultures after hemadsorption, particularly for fungal infections. These findings should be validated in multicenter prospective studies. Clinical trial registration ClinicalTrials.gov , identifier NCT05470907.