#1
JOURNAL ARTICLE
Hye Sung Kim, Yoon Ji Chung, Gyeo Ra Lee, Eun Young Kim
PURPOSE: In septic shock patients, pathogens and excessive endotoxins continuously overstimulate the host's immune system with a cytokine storm that can lead to multi-organ failure and even mortality. Various types of extracorporeal blood purification treatments have recently been introduced to remove excessive endotoxins and cytokines. Herein, we compared the clinical efficacy of two blood purification methods, PMX-HP and AN69-oXiris, and discussed their detailed indications according to disease severity...
2024: Frontiers in Medicine
#2
RANDOMIZED CONTROLLED TRIAL
Takashi Yamamoto, Shun Kunomura, Takumi Taniguchi
INTRODUCTION: The TKM-101 is a new hemofiltration column packed with a polymer alloy membrane consisting of polyethersulfone, polyvinylpyrrolidone, and sulfonated poly (arylene ether) copolymers. We examined the ability of the TKM-101 column to remove cytokines and humoral mediators from blood in vitro and the effects of extracorporeal treatment with the TKM-101 column on the mortality rate and inflammatory responses to endotoxic shock in vivo. METHODS: In vitro and in vivo laboratory investigations were conducted...
2024: Blood Purification
#3
REVIEW
Patrick M Honore, Sydney Blackman, Ibrahim Bousbiat, Emily Perriëns, Rachid Attou
In this chapter, anticoagulation treatments for adsorption techniques in continuous renal replacement therapy (CKRT) will be reviewed. Anticoagulation used with adsorption techniques is quite different than anticoagulation in classical CKRT with nonadsorptive therapies. Regional citrate anticoagulation (RCA) and unfractionated heparin (UFH) are the most common anticoagulation modalities for both nonselective adsorptive membranes - such as surface-treated acrylonitrile 69 membranes (AN69ST) and polymethylmethacrylate membranes - and selective adsorptive membranes such as AN69-oXiris...
2023: Contributions to Nephrology
#4
REVIEW
Matteo Cecchi, Arnau Ulsamer, Gianluca Villa
Sepsis and multiple organ failure (MOF) are characterized by multiple hemodynamic changes and imbalanced immune response of the patient. Oxiris is a highly adsorptive membrane with the ability to remove cytokines and endotoxins, as well as to perform renal replacement therapy. Here we describe the evolution from previous AN69 to the 3-in-1 Oxiris membrane, and review its characteristics and performance. In clinical practice, Oxiris showed consistent effects in mean arterial pressure recovery, a decrease in vasopressor needs, and reduction of the Sequential Organ Failure Assessment score...
2023: Contributions to Nephrology
#5
JOURNAL ARTICLE
Francesca Di Mario, Alice Sabatino, Giuseppe Regolisti, Maria Chiara Pacchiarini, Paolo Greco, Caterina Maccari, Giuseppe Vizzini, Chiara Italiano, Valentina Pistolesi, Santo Morabito, Enrico Fiaccadori
BACKGROUND: Hypophosphatemia is a common electrolyte disorder in critically ill patients undergoing prolonged Kidney Replacement Therapy (KRT). We evaluated the efficacy and safety of a simplified Regional Citrate Anticoagulation (RCA) protocol for Continuous Venovenous Hemofiltration (CVVH), Continuous Venovenous Hemodiafiltration (CVVHDF) and Sustained Low Efficiency Dialysis Filtration (SLED-f). We aimed at preventing KRT-related hypophosphatemia while optimizing acid-base equilibrium...
April 10, 2023: Nephrology, Dialysis, Transplantation
#6
RANDOMIZED CONTROLLED TRIAL
Thummaporn Naorungroj, Ian Baldwin, Glenn Eastwood, Rinaldo Bellomo
BACKGROUNDS: In patients with liver failure, continuous renal replacement therapy (CRRT) without anticoagulation may be necessary. A new heparin coated membrane (oXiris® ) may prolong circuit life in this setting. OBJECTIVES: In liver failure patients not receiving anticoagulation, to compare CRRT circuit life with the oXiris® versus the AN69 ST100 (usual care) membrane. METHODS: Randomized single cross-over trial. RESULTS: We studied 20 patients and 39 circuits...
April 2023: International Journal of Artificial Organs
#7
REVIEW
Shuzo Kobayashi, Takayasu Ohtake
Patients undergoing hemodialysis (HD) experience serious cardiovascular complications, through malnutrition, inflammation, and atherosclerosis. Amputation for peripheral arterial disease (PAD) is more prevalent in patients undergoing HD than in the general population. In addition, revascularization procedures in dialysis patients are often associated with subsequent amputation and high mortality rates. To improve the prognosis of dialysis patients, malnutrition and inflammation must be properly treated, which necessitates a better understanding of the characteristics of dialysis membranes...
January 31, 2023: Journal of Clinical Medicine
#8
RANDOMIZED CONTROLLED TRIAL
Junqi Feng, Shuyi Zhang, Tianyi Ai, Lihui Wang, Yuan Gao, Wen Li, Mingli Zhu
BACKGROUND: Early identification and timely management of septic AKI continue to represent clinical challenges for intensive care. The aim was to evaluate the effect of renal replacement with oXiris filter on clinical outcomes in septic AKI. METHODS: This was a single-center randomized controlled trial that enrolled surgical septic shock with AKI patients admitted in the ICU, Renji Hospital, Shanghai Jiao Tong University, School of Medicine from Jan 1, 2021 to Sep 30, 2021, were screened...
October 2022: International Journal of Artificial Organs
#9
Lana Maričić, Damir Mihić, Tajana Turk, Domagoj Loinjak, Vedran Zubčić
Lemierre's syndrome refers to the septic thrombophlebitis of the internal jugular vein. The condition typically begins with an oropharyngeal infection and frequently involves inflammation within the wall of the vein, infected thrombus within the lumen, surrounding soft tissue inflammation, persistent bacteremia, and septic emboli. Lemierre's syndrome is a rare disease; it occurs most commonly in otherwise healthy young adults. The most common etiologic agent is Fus obacterium necrophorum . We present a case of Lemierre's syndrome in a young girl and the role of extracorporeal method of blood purification with continuous venous hemodiafiltration with the use of a highly adsorptive membrane (AN69 HeprAN), thus achieving the combined elimination of cytokines and endotoxins...
2022: Case Reports in Medicine
#10
JOURNAL ARTICLE
Jing Xie, Wenbiao Xiao, Jiandong Lin
BACKGROUND: Limited previous studies had proved that oXiris-continuous veno-venous hemofiltration (CVVH) could decrease endotoxins and inflammatory factors, thereby improving circulation's stability. However, conclusive data are lacking regarding the comparison between oXiris membrane (with the function of removing endotoxins and decreasing inflammatory factors) and AN69 filters (with the only function of decreasing inflammatory) on the mortality of patients with septic shock. The potential mechanisms of oXiris that might influence the mortality of septic shock patients remain unexplored...
2022: Blood Purification
#11
JOURNAL ARTICLE
Kuo-Hua Lee, Shuo-Ming Ou, Ming-Tsun Tsai, Wei-Cheng Tseng, Chih-Yu Yang, Yao-Ping Lin, Der-Cherng Tarng
Polyacrylonitrile (AN69) filter membranes adsorb cytokines during continuous venovenous hemofiltration (CVVH). Although high-volume hemofiltration has shown limited benefits, the dose-effect relationship in CVVH with AN69 membranes on severe sepsis remains undetermined. This multi-centered study enrolled 266 patients with sepsis-induced multiorgan dysfunction syndrome (MODS) who underwent CVVH with AN69 membranes between 2014 and 2015. We investigated the effects of ultrafiltration rates (UFR) on mortality...
October 29, 2021: Membranes
#12
REVIEW
Tapio Hellman, Panu Uusalo, Mikko J Järvisalo
Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to an infection; it carries a risk for mortality, considerably exceeding that of a mere infection. Sepsis is the leading cause for acute kidney injury (AKI) and the requirement for renal replacement therapy (RRT) in intensive care unit (ICU) patients. Almost every second critically ill patient with sepsis will develop AKI. In septic shock, the dysregulated host response to infectious pathogens leads to a cytokine storm with uncontrolled production and release of humoral proinflammatory mediators that evoke cellular toxicity and promote the development of organ dysfunction and increased mortality...
September 23, 2021: International Journal of Molecular Sciences
#13
Yu Li, Xiao-Jun Ji, Dan-Yang Jing, Zheng-Hui Huang, Mei-Li Duan
BACKGROUND: Septic shock leads to multiple organ failure, and bacterial endotoxins and endogenous cytokines play essential roles in the pathogenesis. The oXiris® hemofilter can efficiently adsorb endotoxins and cytokines. CASE SUMMARY: We admitted a critically ill 59 year-old male patient with gastrointestinal septic shock due to infection by a Gram-negative bacterium and septic acute kidney injury (AKI). Prior to intensive care unit admission, the patient reported intermittent diarrhea and decreased urine output...
September 26, 2021: World Journal of Clinical Cases
#14
COMPARATIVE STUDY
Shouhua Zang, Qing Chen, Yukun Zhang, Li Xu, Jun Chen
INTRODUCTION: The clinical effectiveness of AN69-oXiris remains unclear. This study aimed to compare the effects of AN69-oXiris and AN69-ST filters on cytokine levels and clinical improvement in septic patients. METHODS: This prospective observational study recruited septic patients who underwent blood purification in the First Affiliated Hospital of Soochow University between December 2019 and May 2020. Patients were assigned to an AN69-oXiris (oXiris) or AN69-ST (ST) group based on their preferred filter...
2022: Blood Purification
#15
REVIEW
Yasushi Tsujimoto, Sho Miki, Hiroki Shimada, Hiraku Tsujimoto, Hideto Yasuda, Yuki Kataoka, Tomoko Fujii
BACKGROUND: Acute kidney injury (AKI) is a common complication amongst people who are critically ill, and it is associated with an increased risk of death. For people with severe AKI, continuous kidney replacement therapy (CKRT), which is delivered over 24 hours, is needed when they become haemodynamically unstable. When CKRT is interrupted due to clotting of the extracorporeal circuit, the delivered dose is decreased and thus leading to undertreatment. OBJECTIVES: This review assessed the efficacy of non-pharmacological measures to maintain circuit patency in CKRT...
September 14, 2021: Cochrane Database of Systematic Reviews
#16
Zeynep Karakaya, Muhterem Duyu, Seyma Koksal Atis
Reactions associated with hemodiafiltration can be life threatening if not recognized early in the course of dialysis. AN69 (acrylonitrile and sodium methallyl sulfonate copolymer) membrane-associated reactions during hemodialysis have been documented in adult patients receiving angiotensin converting enzyme inhibitors, which are thought to be triggered by the negative charge of the AN69 membrane. Here, we present a 5-month-old girl requiring continuous renal replacement therapy (CRRT) for acute kidney injury secondary to atypical hemolytic uremic syndrome who experienced acute cyanosis, angioedema, tachycardia, and impaired circulation during CRRT...
January 2022: Hemodialysis International
#17
JOURNAL ARTICLE
Yixue Wang, Zhiping Li, Weiming Chen, Gangfeng Yan, Guangfei Wang, Guoping Lu, Chao Chen
WHAT IS KNOWN AND OBJECTIVE: Meropenem, a broad-spectrum carbapenem, is frequently used to treat severe bacterial infections in critically ill children. Recommendations for meropenem doses in adult infections are available; however, few studies have been published regarding the use of meropenem in children with sepsis, especially in those receiving continuous renal replacement therapy (CRRT) and extracorporeal membrane oxygenation (ECMO). We aimed to investigate the pharmacokinetic (PK) parameters of meropenem in children with sepsis receiving extracorporeal life support (ECLS)...
June 2021: Journal of Clinical Pharmacy and Therapeutics
#18
JOURNAL ARTICLE
Tiantian Wei, Zhiwen Chen, Peiyun Li, Xin Tang, Mark R Marshall, Ling Zhang, Ping Fu
RATIONALE: Septic shock leads to multiple organ failure and increases mortality rate. We reported a critical patient with abdominal septic shock, which was the first case successfully treated with continuous renal replacement therapy (CRRT) and a newly designed endotoxin removal device oXiris in mainland China. PATIENT CONCERNS: A 51-year-old man developed gastric ulcer perforation after resection of a benign peritoneal tumor and had a second abdominal surgery. His blood pressure decreased to 70/40 mm Hg with oliguria, requiring large doses of noradrenaline and intravenous fluid for resuscitation...
July 10, 2020: Medicine (Baltimore)
#19
JOURNAL ARTICLE
Frédéric Joseph Baud, Pascal Houzé, Jean-Herlé Raphalen, Anaïs Winchenne, Pascal Philippe, Pierre Carli, Lionel Lamhaut
INTRODUCTION: In continuous renal replacement therapy, conduction and convection are controlled allowing prescribing dosage regimen improving survival. In contrast, adsorption is an uncontrolled property altering drug disposition. Whether adsorption depends on flowrates is unknown. We hypothesized an in vitro model may provide information in conditions mimicking continuous renal replacement therapy in humans. METHODS: ST150® -AN69 filter and Prismaflex dialyzer, Baxter-Gambro were used...
May 1, 2020: International Journal of Artificial Organs
#20
JOURNAL ARTICLE
Vilmaris Quinones Cardona, Ogechukwu Menkiti
Advances in neonatal care for hypoxic respiratory failure, with high-frequency ventilation and inhaled nitric oxide, have led to a decreased need for extracorporeal membrane oxygenation (ECMO). However, neonates resistant to such therapies are more complex and at higher risk of mortality. One such population includes those with hypoxic ischemic encephalopathy (HIE) undergoing controlled hypothermia (CH). We present a challenging case of a full-term neonate with inotrope-resistant Escherichia coli septic shock, profound coagulopathy, hypoxic respiratory failure, and HIE requiring CH and venoarterial (VA) ECMO...
June 2019: Journal of Extra-corporeal Technology
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