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adsorption AND Sepsis

Tanja Eichhorn, Sabine Rauscher, Caroline Hammer, Marion Gröger, Michael B Fischer, Viktoria Weber
Endothelial activation with excessive recruitment and adhesion of immune cells plays a central role in the progression of sepsis. We established a microfluidic system to study the activation of human umbilical vein endothelial cells by conditioned medium containing plasma from lipopolysaccharide-stimulated whole blood or from septic blood and to investigate the effect of adsorption of inflammatory mediators on endothelial activation. Treatment of stimulated whole blood with polystyrene-divinylbenzene-based cytokine adsorbents (average pore sizes 15 or 30 nm) prior to passage over the endothelial layer resulted in significantly reduced endothelial cytokine and chemokine release, plasminogen activator inhibitor-1 secretion, adhesion molecule expression, and in diminished monocyte adhesion...
October 2016: Inflammation
N J Lees, Ajp Rosenberg, A I Hurtado-Doce, J Jones, N Marczin, M Zeriouh, A Weymann, A Sabashnikov, A R Simon, A F Popov
Sepsis-induced cardiogenic shock in combination with severe acute respiratory failure represents a life-threatening combination that is often refractory to the conventional methods of treatment. We describe the case of a 33-year-old patient who developed acute cardiovascular collapse and ARDS secondary to superinfection of Panton-Valentine leukocidin-positive Staphylococcus aureus and H1N1 pneumonia who underwent successful combination therapy for severe sepsis-related cardiomyopathy and respiratory failure using extracorporeal membrane oxygenation and cytokine adsorption therapy...
July 19, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Francisco Colomina-Climent, Carola Giménez-Esparza, Cristina Portillo-Requena, José Manuel Allegue-Gallego, María Galindo-Martínez, Cristina Mollà-Jiménez, José Luis Antón-Pascual, Manuel Rodríguez-Serra, José Luis Martín-Ruíz, Pablo Juan Fernández-Arroyo, Eugenia María Blasco-Císcar, José Cánovas-Robles, Miguel Herrera-Murillo, Enrique González-Hernández, Fernando Sánchez-Morán, Manuel Solera-Suárez, Jesús Torres-Tortajada, José María Nuñez-Martínez, David Martín-Langerwerf, Eugenio Herrero-Gutiérrez, Isabel Sebastián-Muñoz, Antonio Palazón-Bru, Vicente Francisco Gil-Guillén
INTRODUCTION: There is a lack of evidence in the efficacy of the coupled plasma filtration adsorption (CPFA) to reduce the mortality rate in septic shock. To fill this gap, we have designed the ROMPA study (Mortality Reduction in Septic Shock by Plasma Adsorption) to confirm whether treatment with an adequate dose of treated plasma by CPFA could confer a clinical benefit. METHODS AND ANALYSIS: Our study is a multicentric randomised clinical trial with a 28-day and 90-day follow-up and allocation ratio 1:1...
2016: BMJ Open
M B Yarustovsky, M V Abramyan, N P Krotenko, D A Popov, M G Plyusch, S L Gordeev, E A Rogalskaya
OBJECTIVE: Clinical and laboratory evaluation of the safety and efficacy of combined application of LPS selective adsorption (using cartridges with immobilized polymyxin B on fibers) and plasma filtration and adsorption (CPFA) in patients with severe sepsis after surgery on the heart and blood vessels. MATERIAL AND METHODS: The study involved 40 adult patients with severe sepsis after cardiac surgery. Group I included 20 patients who received the combined therapy with LPS-selective adsorption and CPFA in a single circuit...
September 2015: Anesteziologiia i Reanimatologiia
Yusuke Minematsu, Masafumi Yamato, Yuta Ikemiya, Takahito Ito
BACKGROUND: The most frequent cause of acute kidney injury (AKI) needing renal replacement therapy is sepsis, with the prognosis of patients with septic AKI worse than for other causes of this disease. Recent studies have shown that fibroblast growth factor-23 (FGF-23) levels, one of the phosphaturic and prognostic factors in chronic kidney disease, are also elevated in patients with AKI and correlate with an increased risk of death or a need for dialysis. In addition, FGF-23 was found to inhibit the extra-renal synthesis of 1,25-dihydroxyvitamin D by human monocytes...
2016: Clinical Laboratory
S E Khoroshilov, A V Nikulin, E S Bazhina
OBJECTIVE: To improve the results of abdominal sepsis treatment by comprehensive application of extracorporeal detoxification methods controlled by tissue perfusion. SUBJECT AND METHODS: Fifteen patients with abdominal sepsis were examined, septic shock was diagnosed to all of them. Patients were divided into two groups. The first group (n = 7) consists of patients with acute renal failure, who had undergone adsorption of Lipopolysaccharide. The second group (n = 8) consists of patients with acute renalfailure, who had undergone prolonged hemofiltration regardless of the products of nitrogen metabolism level to terminate systemic inflammatory response...
September 2015: Anesteziologiia i Reanimatologiia
Norio Hanafusa
BACKGROUND: Continuous renal replacement therapy (CRRT) is performed mainly in patients with acute kidney injury, severe sepsis, or septic shock. Evidence has emerged about the indications for and therapeutic conditions of CRRT. In this review, we focus on the evidence for CRRT to date. SUMMARY: CRRT employs diffusion, convection and adsorption to remove solutes from plasma. Indications can be divided into renal and non-renal indications. Concrete renal indications have not yet been determined, except for life-threatening absolute indications...
2015: Blood Purification
Takashi Isobe, Kyoko Kofuji, Kenji Okada, Junya Fujimori, Mikio Murata, Masato Shigeyama, Nobumitsu Hanioka, Yoshifumi Murata
Histones are intracellular proteins that are structural elements of nuclear chromatin and regulate gene transcription. However, the extracellular histones released in response to bacterial challenges have been identified as mediators contributing to endothelial dysfunction, organ failure, and death during sepsis. In the present study, the adsorption of histones as well as plasma proteins (α1-acid glycoprotein (AGP), albumin, and γ-globulin) on alginic acid, pectin, dextran, and chitosan was examined in order to evaluate the potential of natural polysaccharides as therapeutic agents for multiple organ failure in sepsis...
March 2016: International Journal of Biological Macromolecules
Ian Hazzard, S Jones, T Quinn
INTRODUCTION: Coupled plasma filtration and adsorption (CPFA) has been used in the treatment of severe sepsis with the intention of removing the proinflammatory and anti-inflammatory mediators from the systemic circulation. It is believed that this interrupts and moderates the septic cascade, but there is uncertainty about the benefits of this therapy. METHODS: A systematic review and meta-analysis were performed to estimate the effects of CPFA on mortality in severe sepsis...
December 2015: Journal of the Royal Army Medical Corps
Nicholas Lees, A Rosenberg, Aron Popov, Ana Hurtado-Doce, John Jones, Nandor Marczin, Andre Simon
No abstract text is available yet for this article.
December 2015: Critical Care Medicine
Dominic W Chung, Junmei Chen, Minhua Ling, Xiaoyun Fu, Teri Blevins, Scott Parsons, Jennie Le, Jeff Harris, Thomas R Martin, Barbara A Konkle, Ying Zheng, José A López
The ability of von Willebrand factor (VWF) to initiate platelet adhesion depends on the number of monomers in individual VWF multimers and on the self-association of individual VWF multimers into larger structures. VWF self-association is accelerated by shear stress. We observed that VWF self-association occurs during adsorption of VWF onto surfaces, assembly of secreted VWF into hyperadhesive VWF strings on the endothelial surface, and incorporation of fluid-phase VWF into VWF fibers. VWF adsorption under static conditions increased with increased VWF purity and was prevented by a component of plasma...
February 4, 2016: Blood
Stephan Harm, Anna Gruber, Franz Gabor, Jens Hartmann
BACKGROUND/AIMS: Extracorporeal blood purification systems (EBS) use specific adsorbents for the elimination of toxins and cytokines. The aim of this study was to test different adsorbents for their ability to reduce antibiotics in parallel to extracorporeal blood purification therapy. METHODS: The in vitro adsorption experiments were carried out in human plasma with a newly established hydrophobic resin (Amberchrom CG161c) and adsorbents commercially available and approved in the clinics...
2016: Blood Purification
Yoshitaka Hara, Yasuyo Shimomura, Tomoyuki Nakamura, Naohide Kuriyama, Chizuru Yamashita, Yu Kato, Taku Miyasho, Toshikazu Sakai, Shingo Yamada, Kazuhiro Moriyama, Osamu Nishida
Promising results have been reported with blood purification as adjuvant treatment; however, the immunological mechanisms remain unclear. We have been developing a new blood purification system for regulating excessive immune reactions in severe sepsis and septic shock using a granulocyte adsorbing column (Adacolumn [Ada]), and a cytokine-adsorbing hemofilter (AN69ST hemofilter [AN69]). Fresh porcine blood was circulated for 6 h in five experimental groups including Ada and AN69 to assess the effects of leukocyte adsorption, phagocytic activity and adhesiveness of granulocytes...
August 2015: Therapeutic Apheresis and Dialysis
T Eichhorn, S Rauscher, M Gröger, M B Fischer, V Weber
INTRODUCTION: The crucial role of the endothelium in sepsis is well recognized. The aim of this study was to establish a flow model to study endothelial activation induced by lipopolysaccharide (LPS) or by plasma from septic patients. We report on the application of this model to assess the effect of adsorbent-based cytokine modulation on endothelial activation. METHODS: Human whole blood was stimulated with LPS and the stimulated blood or plasma from septic patients was treated in vitro with a polystyrene-divinylbenzene (PS-DVB) adsorbent (average pore size: 30 nm) at an adsorbent-to-plasma ratio of 1:10 (vol/vol)...
October 2015: Shock
S Harm, F Gabor, J Hartmann
INTRODUCTION: For the treatment of severe inflammation, sepsis and septic shock by membrane-adsorption based extracorporeal blood purification technologies, cytokines are basic targets that have to be removed effectively in order to improve the patient's health status. Although there are different adsorbents commercially available, the success of their clinical use is limited. In order to suppress systemic effects in these disease patterns, effective removal of cytokines below a critical threshold is necessary...
October 2015: Shock
Quirino Lai, Verdiana Di Pietro, Samuele Iesari, Sofia Amabili, Linda De Luca, Katia Clemente, Antonio Famulari, Francesco Pisani
Coupled plasma filtration adsorption (CPFA) is an extracorporeal treatment based on plasma filtration associated with an adsorbent cartridge and hemofiltration. CPFA is able to remove inflammatory mediators and it has been used to treat severe sepsis, septic shock and multiple organ dysfunction syndrome. Limited experience exists on the use of CPFA after solid organ transplantation. We report our experience with CPFA in 2 kidney transplant recipients with post-nephrolithotomy septic shock and severe unexplained rhabdomyolysis...
2015: Blood Purification
Gaetano Lucisano, Maria Capria, Giovanni Matera, Pierangela Presta, Nicolino Comi, Roberta Talarico, Linda Rametti, Angela Quirino, Aida Giancotti, Giorgio Fuiano
Coupled plasma filtration adsorption (CPFA) is an extracorporeal blood purification therapy based on non-specific pro- and anti-inflammatory mediator adsorption on a special resin cartridge coupled with continuous veno-venous haemofiltration or continuous veno-venous haemodiafiltration and is one of the emerging treatments for septic patients. However, in the literature, there are limited data about its efficacy in treating patients with acute diseases but without the traditional criteria for sepsis. We describe the case of a 43-year-old male who developed acute respiratory distress syndrome secondary to pneumonia and acute kidney injury, whose clinical conditions rapidly improved after early CPFA therapy...
October 2011: NDT Plus
Michail Yaroustovsky, Marina Abramyan, Nickolay Krotenko, Dmitry Popov, Marina Plyushch, Ekaterina Rogalskaya
AIM: To evaluate the safety and effectiveness of combined extracorporeal therapy in patients with severe sepsis after cardiac surgery. MATERIALS AND METHODS: Twenty patients received combined extracorporeal therapy (LPS-adsorption with Toraymyxin columns + CPFA). The inclusion criteria were clinical signs of severe sepsis, EAA = 0.6, and PCT >2 ng/ml. 20 comparable patients in the control group received only standard therapy. RESULTS: Each patient in the study group received 2 daily treatments of combined extracorporeal therapy...
2015: Blood Purification
Xuefeng Xu, Huaping Dai, Chun'e Jia, Chen Wang
OBJECTIVE: To discuss the rationale, hypothesis, modality of extracorporeal blood purification (EBP) techniques for the critically ill animal models or patients, and to summarize the experimental and clinical studies with inconsistent data which explored the EBP's efficacy in the areas of critical care medicine. DATA SOURCES: Articles referred in this review were collected from the database of PubMed published in English up to June 2014. STUDY SELECTION: We had done a literature search by using the term "(sepsis OR acute lung injury OR acute respiratory distress syndrome) AND (extracorporeal blood purification OR hemofiltration OR hemoperfusion OR plasma exchange OR plasmapheresis OR adsorpiton)"...
2014: Chinese Medical Journal
M B Iarustovskiĭ, M V Abramian, N P Krotenko, D A Popov, M G Pliushch, E I Nazarova, S L Gordeev
PURPOSE OF THE STUDY: To evaluate the safety and effectiveness of selective lipopolysaccharide (LPS)-adsorption therapy using polymyxin B immobilised fibre cartridges in adult patients complicated with severe sepsis after cardiac surgery. METHODS: 105 patients received extracorporeal LPS-adsorption procedures using Toraymyxin columns--PMX (Toray, Japan) in addition to the standard treatment according to the Surviving Sepsis Campaign guideline study group. For control group we selected 40 patients, comparable by PMX group in age, body weight, severity of illness, and the duration of cardiopulmonary bypass, received only standard therapy...
May 2014: Anesteziologiia i Reanimatologiia
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