Continuous veno-venous hemofiltration with dialysis removes cytokines from the circulation of septic patients

Bellomo, Rinaldo; Tipping, Peter G.; Boyce, Neil

doi:10.1097/00003246-199304000-00011

Cited by 354 publications

(141 citation statements)

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“…Haemodialysis is effective in removing mediators, such as IL-6, IL-8 and TNF-a [62][63][64][65][66][67][68]; however, to date, no study of either haemodialysis or plasmapheresis has specifically targeted ALI patients. Targeting of multiple agents would be of interest because, as discussed previously, it is unlikely that the modulation of any one mediator or pathway will be successful in achieving better outcomes.…”

Section: Biotraumamentioning

confidence: 99%

Ventilator-associated lung injury: a search for better therapeutic targets

Oeckler¹,

Hubmayr²

2007

Eur Respir J

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Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) represent a continuum of injury that may arise from a number of primary insults.Localised injury may progress due to trauma from mechanical ventilation, a finding that has led to intense debate in the clinical and experimental literature over optimal ventilator management. The implementation of low tidal volume strategies has led to an improvement in outcomes; however, mortality remains unacceptably high.In the current review, ventilator-associated lung injury is examined, as it relates to the pathophysiological changes beyond direct airway trauma in ALI and ARDS, and an attempt is made to provide a historical perspective to outline potential current and future pitfalls in the use of surrogate end-points and the discovery of potential biomarkers. The systemic responses that lead to multi-organ dysfunction, the leading causes of morbidity and mortality in ALI and ARDS, are caused by pro-inflammatory signalling cascades and the activation of such diverse mediators as reactive oxygen species, immune response elements, apoptotic constituents and coagulation proteins.These areas are examined, including key mediators, and possible future areas of interest are discussed, including the potential of an ''acute lung injury chip'' to integrate measured surrogate biomarkers with real-time clinical information to improve patient outcomes.

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Section: Biotraumamentioning

confidence: 99%

Ventilator-associated lung injury: a search for better therapeutic targets

Oeckler¹,

Hubmayr²

2007

Eur Respir J

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“…Although various treatments for sepsis have been used, none has been sufficient. Of the available options, blood purification therapy for cytokine removal is reported to be successful [4]. With regard to high-flow and high-volume renal replacement therapy, results have been positive [5,6] or negative [7,8], with no clear conclusion.…”

Section: Introductionmentioning

confidence: 99%

Effect of continuous hemodiafiltration using an AN69ST membrane in patients with sepsis

et al. 2017

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Background: Sepsis is a systemic inflammatory response syndrome caused by infectious disease. Severe sepsis and septic shock are extremely serious conditions with poor prognoses. It is reported that cytokines are deeply involved in the disease mechanism. Continuous hemodiafiltration (CHDF) using a poly(methyl methacrylate) (PMMA) membrane is reported to adsorb various cytokines and improve the status of patients with sepsis. Recently, another cytokine-adsorbing hemofilter, acrylonitrile-co-methallyl sulfonate surface-treated (AN69ST) membrane, has become available for CHDF in patients with sepsis. However, the clinical efficacy of this membrane remains unclear. Therefore, in this study, we compared the efficacy of AN69ST and PMMA membranes.

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“…20 Although we cannot prove that continuous veno-venous hemodiafiltration normalized the elevated levels of cytokines that have been implicated in the severe tissue damage in HLH, our patient's condition stabilized after he was started on RRT. In addition, when dialysis was discontinued, he experienced an overall disease relapse, including AKI, which again responded well to three doses of intravenous methylprednisolone.…”

Section: Discussionmentioning

confidence: 61%

Direct Reversible Kidney Injury in Familial Hemophagocytic Lymphohistiocytosis Type 3

Malaga-Dieguez¹,

Wu²,

Trachtman³

2015

Journal of the American Society of Nephrology

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Hemophagocytic lymphohistiocytosis is a hyperinflammatory disorder resulting from primary or secondary immune dysfunction. AKI is frequent in severe hemophagocytic lymphohistiocytosis and has been attributed to multiorgan failure or the use of nephrotoxic drugs, but AKI is rarely considered a direct consequence of the disease process. We describe a child with familial hemophagocytic lymphohistiocytosis type 3 who developed AKI requiring prolonged renal replacement therapy because of severe renal inflammation. There was massive infiltration of the renal parenchyma by activated macrophages and cytotoxic T cells, and acute tubular injury. The patient responded to high-dose intravenous methylprednisolone, which resulted in improvement of renal function and discontinuation of renal replacement therapy. This case confirms the occurrence of reversible AKI due to hemophagocytic lymphohistiocytosis-induced activated macrophage infiltration of the renal parenchyma and inflammation.

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Continuous veno-venous hemofiltration with dialysis removes cytokines from the circulation of septic patients

Cited by 354 publications

References 0 publications

Ventilator-associated lung injury: a search for better therapeutic targets

Ventilator-associated lung injury: a search for better therapeutic targets

Effect of continuous hemodiafiltration using an AN69ST membrane in patients with sepsis

Direct Reversible Kidney Injury in Familial Hemophagocytic Lymphohistiocytosis Type 3

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