Practical points of hemoperfusion in the intensive care unit

Abstract

In cases of critical illness, some patients may experience adverse outcomes due to the excessive release of mediators or exposure to various toxins. These conditions can potentially lead to multi-organ failure and, ultimately, death. Hemoperfusion has emerged as an increasingly utilized method for blood purification, involving the removal of solutes by binding them to adsorbent materials. Currently, this technique is being employed in intensive care units to effectively clear many of the mediators and improve these critical conditions. Hemoperfusion has demonstrated promising results in various conditions, including sepsis, severe Acute Respiratory Distress Syndrome (ARDS), acute liver failure, and severe Coronavirus Disease 2019 (COVID-19). Nonetheless, ongoing trials investigating various hemoperfusion techniques have yielded mixed results, necessitating further confirmation through additional studies. Drawing upon my clinical experience and existing evidence, I advocate for a more personalized approach to initiating hemoperfusion therapy. I recommend evaluating each case individually and tailoring the treatment to optimize outcomes.