Choosing New Adsorbents for Endogenous Ultrapure Infusion Fluid: Performances, Safety and Flow Distribution

Nitti, C. De; Giordano, R.; Gervasio, R; Castellano, Giancarlo; Podio, Valerio; Sereni, Luisa; Ghezzi, P; Ronco, Claudio; Brendolan, Alessandra; Inguaggiato, Paola; Greca, G. La; Tetta, Ciro

doi:10.1177/039139880102401102

Cited by 19 publications

(9 citation statements)

References 20 publications

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“…These limitations have produced new enthusiasm for adsorbent technology (75–78). Uncoated adsorbents (i.e., maximizing their adsorptive ability) could, in fact, allow the regeneration of ultrafiltrate or plasma, which would then be used as reinfusion fluids without the need for exogenous supplementation.…”

Section: Novel Trendsmentioning

confidence: 99%

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Artificial Organ Treatment for Multiple Organ Failure, Acute Renal Failure, and Sepsis: Recent New Trends

2003

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Sepsis remains the major cause of mortality worldwide, claiming millions of lives each year. The past decade has seen major advances in the understanding of the biological mechanisms involved in this complex process. Unfortunately, no definitive therapy yet exists that can successfully treat sepsis and its complications. At variance with targeting single mediators, therapeutic intervention aimed at the nonselective removal of pro- and anti-inflammatory mediators seems a rational concept and a possible key to successful extracorporeal therapies. A further advantage may lie in the continuous nature of such therapy. With such continuous therapy, sequentially appearing peaks of systemic mediator overflow may be attenuated and persistently high plasma levels reduced. This theoretical framework is proposed as the underlying biological rationale for a series of innovative modalities in sepsis. In this editorial, we will review recent animal and human trials that lend support to this concept. We will also review the importance of treatment dose during continuous renal replacement therapy as a major factor affecting survival in critically ill patients with acute renal failure. Additionally, we will review novel information related to other blood purification techniques using large pore membranes or plasma filtration with adsorbent perfusion. Although these approaches are still in the early stages of clinical testing, they are conceptually promising and might represent an important advance.

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Section: Novel Trendsmentioning

confidence: 99%

“…Carbons per se represent a rather complex family of inert materials, which have very different characteristics and biocompatibility, as reviewed in ref. 78 ( Table 1). The use of microparticles may result in greater accessibility and higher adsorption capacity due to smaller diffusion distances.…”

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confidence: 99%

Artificial Organ Treatment for Multiple Organ Failure, Acute Renal Failure, and Sepsis: Recent New Trends

2003

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“…De Nitti et al. have reported that adsorbents very similar to the one used in our study are able to adsorb low‐molecular‐weight toxins (16). This should help to maintain lower interdialytic levels of tHcy.…”

Section: Discussionmentioning

confidence: 71%

Selective Adsorption of Homocysteine Using an HFR‐ON LINE Technique

et al. 2004

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HFR-ON LINE (double chamber HDF with reinfusion of ultrafiltrate regenerated through a charcoal-resin cartridge) is a novel method which combines the processes of diffusion, convection, and adsorbance. We have investigated the effect of such a treatment on the homocysteine (Hcy) levels in ten patients with a mean Hcy level of 57.6 micromol/L (range 24.1-119.7 micromol/L). We have measured the Hcy, folate, and vitamin B12 predialysis and postdialysis, and in the ultrafiltrate precartridge and postcartridge at 10, 120, and 240 min. The mean Hcy levels were 57.6 and 35.3 micromol/L (range 9.9-80.3 micromol/L) (P = 0.005) predialysis and postdialysis, respectively, while folate and vitamin B12 were unchanged. Precartridge and postcartridge Hcy levels were 11.6 vs. 2.5 micromol/L (P = 0.005), 9.3 vs. 3.9 micromol/L (P = 0.005), and 7.7 vs. 4.6 micro mol/L (P = 0.012) at the three time points considered, while folate and vitamin B12 were essentially undetectable. These preliminary data, which need confirmation in a long-term study, seem to indicate that HFR-ON LINE is able to reduce Hcy levels not only through a likely reduction of uremic toxins, but also through an actual removal of Hcy by adsorbance onto the charcoal-resin cartridge.

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“…De Nitti et al [10] described the methodological approach for screening stationary matrices for possible application in EBPT. Synthetic resins have largely overcome the high variability of charcoal, which depends on source, site and extraction procedures.…”

Section: Adsorbentsmentioning

confidence: 99%

Extracorporal blood purification: more than diffusion and convection. Does this help?

Ronco

Tetta

2007

Current Opinion in Critical Care

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Choosing New Adsorbents for Endogenous Ultrapure Infusion Fluid: Performances, Safety and Flow Distribution

Cited by 19 publications

References 20 publications

Artificial Organ Treatment for Multiple Organ Failure, Acute Renal Failure, and Sepsis: Recent New Trends

Artificial Organ Treatment for Multiple Organ Failure, Acute Renal Failure, and Sepsis: Recent New Trends

Selective Adsorption of Homocysteine Using an HFR‐ON LINE Technique

Extracorporal blood purification: more than diffusion and convection. Does this help?

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