Mathieu Page1, Thomas Rimmelé. 1. Département d'anesthésie réanimation, pavillon P réanimation, Hôpital Edouard Herriot, 5 place d'Arsonval, 69437 Lyon Cedex 03 France. page.mat@gmail.com
Abstract
PURPOSE: Septic shock is the leading cause of multiple organ failure and mortality in intensive care units. This condition seems to be related to an overproduction of both pro- and anti-inflammatory mediators, leading to an immunological dysfunction. Therapeutic strategies aimed at reducing blood and tissue concentrations of these mediators have been developed. One of these techniques, based on extra-renal filtration, is called "coupled plasma filtration and adsorption". SOURCE: English and French language articles published between 1984 and 2008 were identified through a computerized Medline search. Keywords and MeSH terms used were: "coupled plasmafiltration", "coupled plasma filtration", "adsorption", "blood purification", "cytokines", "hemofiltration", "sepsis". Relevant publications were retrieved and scanned for additional sources. Nine publications were found. PRINCIPAL FINDINGS: Coupled plasma filtration adsorption is an extra-corporeal treatment, based on non-specific cytokine adsorption on a specially designed resin cartridge, coupled with hemofiltration. Experimental studies and the first clinical trials have shown interesting results regarding hemodynamics and respiratory parameters. However, these trials failed to demonstrate any improvement in outcome. CONCLUSION: Additional evidence is needed to clarify the role of this blood purification technique for the treatment of septic shock.
PURPOSE:Septic shock is the leading cause of multiple organ failure and mortality in intensive care units. This condition seems to be related to an overproduction of both pro- and anti-inflammatory mediators, leading to an immunological dysfunction. Therapeutic strategies aimed at reducing blood and tissue concentrations of these mediators have been developed. One of these techniques, based on extra-renal filtration, is called "coupled plasma filtration and adsorption". SOURCE: English and French language articles published between 1984 and 2008 were identified through a computerized Medline search. Keywords and MeSH terms used were: "coupled plasmafiltration", "coupled plasma filtration", "adsorption", "blood purification", "cytokines", "hemofiltration", "sepsis". Relevant publications were retrieved and scanned for additional sources. Nine publications were found. PRINCIPAL FINDINGS: Coupled plasma filtration adsorption is an extra-corporeal treatment, based on non-specific cytokine adsorption on a specially designed resin cartridge, coupled with hemofiltration. Experimental studies and the first clinical trials have shown interesting results regarding hemodynamics and respiratory parameters. However, these trials failed to demonstrate any improvement in outcome. CONCLUSION: Additional evidence is needed to clarify the role of this blood purification technique for the treatment of septic shock.
Authors: Gaetano Lucisano; Maria Capria; Giovanni Matera; Pierangela Presta; Nicolino Comi; Roberta Talarico; Linda Rametti; Angela Quirino; Aida Giancotti; Giorgio Fuiano Journal: NDT Plus Date: 2011-07-06