Multiple-Organ Extracorporeal Support Therapies in Critically Ill Patients

Daza, José Lucas; Ferro, María C. Correcha; Cardenas, Andrés David; Daza, Luis; Rey, EJ Alegre-Del; Jong, Jonathan de; Galindo, John; Gutiérrez, Gerardo; Puello, Luis; Cruz, Yaroslad de la

doi:10.4236/ojneph.2021.112023

Cited by 2 publications

(3 citation statements)

References 54 publications

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“…Blood purification therapies: MODS caused due to an excessive release of cytokines and inflammatory mediators is a major cause of ICU morbidity and mortality in sepsis[ 27 ]. Blood purification therapies (BPTs) are the strategies proposed to restore the immune balance by eliminating or deactivating the inflammatory mediators and originates as an off-shoot of renal replacement therapy (RRT).…”

Section: Resultsmentioning

confidence: 99%

“…Blood purification therapies (BPTs) are the strategies proposed to restore the immune balance by eliminating or deactivating the inflammatory mediators and originates as an off-shoot of renal replacement therapy (RRT). Various approaches have been identified to maximize the effect of RRT, which include HVHF, high cut-off membranes (HCO), hemadsorption techniques alone or in combination and coupled plasma filtration adsorption (CPFA)[ 9 , 15 , 27 ]. Studies determining the efficacy of different modalities in cytokine and endotoxin removal are presented in Table 1 [ 28 - 33 ].…”

Section: Resultsmentioning

confidence: 99%

“…With the diffusion process, the solute is transported through a semi permeable membrane down/across its concentration gradient, whereas in convection, solute transport happens as part of solvent drag, and ultrafiltration is driven by a transmembrane pressure gradient. In hemadsorption, blood is passed through sorbents which attract the solutes to adhere to them (adsorb), through a series of hydrophobic and ionic interactions[ 27 , 40 ]. Solute clearance by diffusion depends on molecular weight (MW), membrane permeability, dialysate flow and surface area.…”

Section: Extracorporeal Therapy In Sepsismentioning

confidence: 99%

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Extracorporeal blood purification strategies in sepsis and septic shock: An insight into recent advancements

Mehta¹,

Paul²,

Ansari³

et al. 2023

World J Crit Care Med

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BACKGROUND Despite various therapies to treat sepsis, it is one of the leading causes of mortality in the intensive care unit patients globally. Knowledge about the pathophysiology of sepsis has sparked interest in extracorporeal therapies (ECT) which are intended to balance the dysregulation of the immune system by removing excessive levels of inflammatory mediators. AIM To review recent data on the use of ECT in sepsis and to assess their effects on various inflammatory and clinical outcomes. METHODS In this review, an extensive English literature search was conducted from the last two decades to identify the use of ECT in sepsis. A total of 68 articles from peer-reviewed and indexed journals were selected excluding publications with only abstracts. RESULTS Results showed that ECT techniques such as high-volume hemofiltration, coupled plasma adsorption/filtration, resin or polymer adsorbers, and CytoSorb ® are emerging as adjunct therapies to improve hemodynamic stability in sepsis. CytoSorb ® has the most published data in regard to the use in the field of septic shock with reports on improved survival rates and lowered sequential organ failure assessment scores, lactate levels, total leucocyte count, platelet count, interleukin- IL-6, IL-10, and TNF levels. CONCLUSION Clinical acceptance of ECT in sepsis and septic shock is currently still limited due to a lack of large random clinical trials. In addition to patient-tailored therapies, future research developments with therapies targeting the cellular level of the immune response are expected.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Extracorporeal Therapy In Sepsismentioning

confidence: 99%

See 1 more Smart Citation

Extracorporeal blood purification strategies in sepsis and septic shock: An insight into recent advancements

Mehta¹,

Paul²,

Ansari³

et al. 2023

World J Crit Care Med

View full text Add to dashboard Cite

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Dialoxygenation: A Preclinical Trial for Transforming the Artificial Kidney Into an Oxygenator

Karacanoğlu,

Bedir,

Nakip

et al. 2024

ASAIO Journal

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Critically ill patients sometimes require tandem application of extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) which is easier and cheaper. We aimed to transform the kidney membrane into a lung membrane by adding hydrogen peroxide (H2O2) to the dialysate as the oxygen source. A solution containing H2O2 and a dialysate fluid mixture was used as the final dialysate. Starting with 100% H2O2 solution and gradually reducing the volume of H2O2, respectively: 50%, 10%, 5%, 4%, 3%, 2%, and 1%. PRISMAFLEX system, Prismaflex M60 set and a bag of packed red blood cells (pRBCs) were the prototype. blood flow rate was about 40 ml/minute and the dialysis rate was about 200 ml/m2/minute/1.73 m2. blood sampling times were; at the beginning (T 0), at 15th (T 1), 30th (T 2), 60th (T 3) minutes. Amongst eight attempts H2O2 concentration that increased the partial oxygen pressure (pO2) level significantly in a reasonable period, without any bubbles, was 3%. Methemoglobinemia was not observed in any trial. After the test with 3%, H2O2 in the dialysate fluid decreased progressively without any H2O2 detection at post-membrane blood. Three percent H2O2 solution is sufficient and safe for oxygenation in CRRT systems. With this new oxy-dialysate solution, both pulmonary and renal replacement can be possible via a single membrane in a simpler manner.

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Multiple-Organ Extracorporeal Support Therapies in Critically Ill Patients

Cited by 2 publications

References 54 publications

Extracorporeal blood purification strategies in sepsis and septic shock: An insight into recent advancements

Extracorporeal blood purification strategies in sepsis and septic shock: An insight into recent advancements

Dialoxygenation: A Preclinical Trial for Transforming the Artificial Kidney Into an Oxygenator

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