Continuous Hemodiafiltration with a Cytokine-Adsorbing Hemofilter for Sepsis

被引：45

作者：

Hirasawa, Hiroyuki ^{[1
]}

Oda, Shigeto

Nakamura, Masataka

Watanabe, Eizo

Shiga, Hidetoshi ^{[2
]}

Matsuda, Kenichi ^{[3
]}

机构：

[1] Chiba Univ, Dept Emergency & Crit Care Med, Grad Sch Med, Chuo Ku, Chiba 2608677, Japan

[2] Teikyo Univ, Dept Emergency & Crit Care Med, Chiba Med Ctr, Chiba, Japan

[3] Yamanashi Univ, Dept Emergency & Crit Care Med, Sch Med, Yamanashi, Japan

来源：

BLOOD PURIFICATION | 2012年 / 34卷 / 02期

关键词：

Hypercytokinemia; Pathogen-associated molecular patterns; Alarmin; Endotoxin; Cytokine-adsorbing hemofilter; Polymethyl methacrylate hemofilter; AN69ST hemofilter; Continuous hemodiafiltration; High-volume continuous hemofiltration; Direct hemoperfusion with polymyxin-B-immobilized column; HIGH-VOLUME HEMOFILTRATION; CONTINUOUS VENOVENOUS HEMOFILTRATION; RANDOMIZED CONTROLLED-TRIAL; TUMOR-NECROSIS-FACTOR; ACUTE-RENAL-FAILURE; SEPTIC SHOCK; BLOOD PURIFICATION; MEMBRANE HEMOFILTER; CRITICALLY-ILL; CRITICAL-CARE;

D O I：

10.1159/000342379

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Since the introduction of the new pathophysiological concept of pathogen-associated molecular patterns (PAMPS) and alarmins, endotoxin has been recognized as only one of the PAMPS. It is widely accepted that hypercytokinemia plays a pivotal role in the pathophysiology of sepsis. Many kinds of blood purification modalities have been proposed as a therapeutic tool against sepsis, including high-volume continuous hemofiltration whose efficacy has recently been questioned. We report that continuous hemodiafiltration (CHDF) with a cytokine-adsorbing hemofilter (CAH), such as polymethyl methacrylate hemofilter and AN69ST hemofilter (CAH-CHDF), can remove many kinds of cytokines and has been very effective in the treatment of severe sepsis and septic shock. Based on the understanding of the recent pathophysiology, we suggest that CAH-CHDF is an alternate therapy to direct hemoperfusion with endotoxin-adsorbing column in the treatment of sepsis. Copyright (C) 2012 S. Karger AG, Basel

引用

页码：164 / 170

页数：7

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