Organ Crosstalk in Critically Ill Patients: Hemofiltration and Immunomodulation in Sepsis

Schefold, Joerg C.; Hasper, Dietrich; Jörres, Achim

doi:10.1159/000223361

Cited by 18 publications

(14 citation statements)

References 105 publications

(63 reference statements)

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“…25 Organ cross-talk is an emerging, interesting, and clinically relevant field. [26][27][28][29][30] Currently, little is known about the intrinsic pathway and pathophysiological mechanisms of medical complications cross-talk after acute stroke. Accumulating evidence indicated that acute stroke could induce significant immunologic changes such as stroke-induced immunodepression, 31,32 which was a key facilitating factor for poststroke infection, especially pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Interrelationship Among Common Medical Complications After Acute Stroke

Wang

Shen³

et al. 2013

Stroke

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Although several studies have systematically investigated medical complications after stroke, 3,5-13 much attention was paid to specific complications and few studies have focused on investigating the potential interrelationship among them. In daily clinical practice, it is common for patients with stroke to experience multiple medical complications (≥2) during acute hospitalization, especially for those patients with severe neurological deficit. 11,14,15 It is still unclear whether these strokeassociated medical complications occur independently or not, and if not, what is the potential association among them? The answers to these questions might shed some light on uncovering pathophysiological mechanisms underlying multiple medical complications after acute stroke and developing novel preventive strategies to improve stroke outcome.In the present study, we aimed to examine the correlation and association between common medical complications after acute stroke. To draw convincing conclusions, we tested our findings in acute ischemic stroke (AIS) and spontaneous intracerebral hemorrhage (ICH) cohorts, respectively.Background and Purpose-Medical complications are common among patients with stroke. However, little is known about the potential interrelationship among them. In the present study, we aimed to investigate the association between common in-hospital medical complications after acute ischemic stroke (AIS) and spontaneous intracerebral hemorrhage (ICH

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Section: Discussionmentioning

confidence: 99%

Interrelationship Among Common Medical Complications After Acute Stroke

Wang

Shen³

et al. 2013

Stroke

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“…Advancement in the field of intensive care has not resulted in improved outcomes for this cohort [38]. The accompanying hypercytokinemia is believed to be harmful, and nonspecific removal of cytokines seems desirable [39].…”

Section: Discussionmentioning

confidence: 99%

Techniques of Extracorporeal Cytokine Removal: A Systematic Review of the Literature

2012

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Background and Aims: Attempts at achieving cytokine homeostasis include blood purification to deliver cytokine removal. Assessment of ex vivo studies for optimal operating conditions is a vital step. Methods: We conducted a systematic search for ex vivo studies on cytokine removal using known modalities of extracorporeal circulation. We selected 29 articles and analyzed data according to clearance, sieving coefficient, ultrafiltrate concentration and percentage removal. Results: We identified four main techniques for cytokine removal: standard techniques, high cut-off (HCO) techniques, adsorption techniques and combined plasma filtration adsorption. HCO hemofiltration (HCO/HF) showed greatest consistency in cytokine removal among all approaches. Mean albumin clearance with HCO filters was 3.74 ml/min. Conclusion: Ex vivo data support the view that HCO/HF is the most consistently effective approach in terms of sieving and clearance. Further investigation of HCO/HF in randomized controlled trials in animal models and humans seems desirable.

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“…Simultaneously, various cytokine removal technologies have been applied to the treatment of critically ill patients with hypercytokinemia, such as severe sepsis and septic shock [14,[25][26][27][28][29][30]. In these studies, many investigations reported that the various types of blood purification therapy could improve the survival of critically ill patients with hypercytokinemia from about 30% to about 60%.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Efficacy between Continuous Hemodiafiltration with a PMMA High-Performance Membrane Dialyzer and a PAN Membrane Hemofilter in the Treatment of Septic Shock Patients with Acute Renal Failure

Matsuda¹,

Moriguchi²,

Harii³

et al. 2011

Contributions to Nephrology

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The aim of this study was to investigate whether continuous hemodiafiltration (CHDF) with a high-performance membrane dialyzer made of polymethylmethacrylate (PMMA-CHDF) in the treatment of septic shock patients with acute renal failure (ARF) is clinically relevant. 30 patients were treated with PMMA-CHDF. 13 patients treated with CHDF used a hemofilter made of polyacrylonitrile membrane (PAN-CHDF). Systolic blood pressure significantly increased in the PMMA-CHDF group following 24 h of treatment (p < 0.01), whereas it did not improve in the PAN-CHDF group. Urine volume significantly increased in the PMMA-CHDF group following 24 h of treatment which was more than in the PAN-CHDF group (p < 0.05). 28-day survival was 83.3% in the PMMA-CHDF group and 30.8% in the PAN-CHDF group, respectively (p < 0.01). We can assume that PMMA-CHDF in the treatment of septic shock patients with ARF is clinically relevant.

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Organ Crosstalk in Critically Ill Patients: Hemofiltration and Immunomodulation in Sepsis

Cited by 18 publications

References 105 publications

Interrelationship Among Common Medical Complications After Acute Stroke

Interrelationship Among Common Medical Complications After Acute Stroke

Techniques of Extracorporeal Cytokine Removal: A Systematic Review of the Literature

Comparison of Efficacy between Continuous Hemodiafiltration with a PMMA High-Performance Membrane Dialyzer and a PAN Membrane Hemofilter in the Treatment of Septic Shock Patients with Acute Renal Failure

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