Endothelial Protection and Improved Micro- and Macrocirculation with Hemoadsorption in Critically Ill Patients

被引：1

作者：

Papp, Marton ^{[1
,2
]}

Ince, Can ^{[3
]}

Bakker, Jan ^{[4
,5
,6
,7
]}

Molnar, Zsolt ^{[1
,2
,8
]}

机构：

[1] Semmelweis Univ, Dept Anesthesiol & Intens Therapy, 78 Ullo St, H-1082 Budapest, Hungary

[2] Semmelweis Univ, Ctr Translat Med, 22 Bar St, H-1085 Budapest, Hungary

[3] Univ Med Ctr Rotterdam, Dept Intens Care, Lab Translat Intens Care, Erasmus MC, NL-3015 GD Rotterdam, Netherlands

[4] NYU, Dept Pulm & Crit Care, Sch Med, New York, NY 10016 USA

[5] Columbia Univ, Div Pulm Allergy & Crit Care Med, Coll Phys & Surg, New York, NY 10032 USA

[6] Erasmus MC Univ, Dept Intens Care Adults, Med Ctr, NL-3000 GD Rotterdam, Netherlands

[7] Pontificia Univ Catolica Chile, Dept Intens Care, Santiago 8320165, Chile

[8] Poznan Univ Med Sci, Dept Anesthesiol & Intens Therapy & Pain Med, 49 Przybyszewskiego St, PL-60355 Poznan, Poland

来源：

JOURNAL OF CLINICAL MEDICINE | 2024年 / 13卷 / 23期

关键词：

sepsis; septic shock; hemoadsorption; cytokines; endothelium; capillary leakage; SEPTIC SHOCK; INFLAMMATORY RESPONSE; CYTOKINE REMOVAL; SEPSIS; RESUSCITATION; ACTIVATION; MORTALITY; ADSORBENT; RECEPTOR; THERAPY;

D O I：

10.3390/jcm13237044

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

A dysregulated immune response is associated with an excessive release of cytokines that can lead to systemic vasoplegia and vasoplegic shock with the development of multiorgan failure that is associated with an increased risk of dying. Under physiological circumstances, the endothelium and the glycocalyx are responsible for maintaining vascular tone, capillary permeability, and hemostasis, and controlling inflammation. In hyperinflammation, the endothelium and glycocalyx become damaged due to the excessive production of certain toxic proteins, along with an overwhelming release of cytokines. It has been shown in both in vitro animal experiments and in humans that extracorporeal hemoadsorption can reduce circulating levels of cytokines and may also remove toxic proteins that directly take part in endothelium and glycocalyx damage. The current review aims to summarize current knowledge, put recent findings into context, and introduce the hypothesis of "endothelial protection with hemoadsorption" in critically ill patients.

引用

页数：9

共 64 条

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