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adsorption AND Sepsis

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https://www.readbyqxmd.com/read/29732183/extracorporeal-membrane-oxygenation-and-cytokine-adsorption
#1
REVIEW
Thomas Datzmann, Karl Träger
Extracorporeal membrane oxygenation (ECMO) is an increasingly used technology for mechanical support of respiratory and cardio-circulatory failure. Excessive systemic inflammatory response is observed during sepsis and after cardiopulmonary bypass (CPB) with similar clinical features. The overwhelming inflammatory response is characterized by highly elevated pro- and anti-inflammatory cytokine levels. The excessive cytokine release during the overwhelming inflammatory response may result in multiple organ damage and failure...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29728790/in-vitro-comparison-of-the-adsorption-of-inflammatory-mediators-by-blood-purification-devices
#2
Benjamin Malard, Corine Lambert, John A Kellum
BACKGROUND: Septic shock, a leading cause of acute kidney injury, induces release of pro-/anti-inflammatory mediators, leading to increased mortality and poor renal recovery. This is the first in vitro study directly comparing three single-use blood purification devices in terms of removing sepsis-associated mediators and endotoxins. METHODS: In vitro hemoperfusion was performed using oXiris® , CytoSorb® , and Toraymyxin® . Heparinized human plasma from healthy volunteers was pre-incubated with pathologic quantities of inflammatory mediators and filtered in a closed-loop circulation model for 2 h...
May 4, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29597218/membranes-and-sorbents
#3
William R Clark, Dayong Gao, Anna Lorenzin, Claudio Ronco
For continuous renal replacement therapy (CRRT), the extracorporeal filter provides solute depuration, fluid removal, and control of electrolyte and acid-base balance in critically ill patients with acute kidney injury (AKI). The membranes comprising CRRT filters are almost exclusively based on hollow fiber designs and, while adapted from the chronic hemodialysis field, have features that are specific to the requirements of CRRT nevertheless. In addition, these devices have evolved through the 40 years of CRRT in response to changes in clinical practice and the desire to extend the solute removal spectrum...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29429201/-survey-on-the-prevalence-of-continuous-blood-purification-in-chinese-pediatric-critical-care
#4
X Yang, S Y Qian, Y M Zhu, X Xu, C F Liu, F Xu, X X Ren, Y Wang, Y C Zhang, G P Lu
Objective: To investigate the current application status of continuous blood purification (CBP) technology and equipment in pediatric intensive care unit (PICU) in China. Methods: A cross-sectional survey was conducted to understand the current popularization of CBP technology and equipment, the management of CBP equipment and consumables, and the application of CBP in different diseases. A questionnaire named Application Status of Continuous Blood Purification Technology was applied. Children's hospitals and polyclinic hospitals with the pediatric qualification (pediatric emergency or critical care unit members of Chinese Medical Association and Chinese Medical Doctor Association) were selected...
February 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29370247/broad-adsorption-of-sepsis-related-pamp-and-damp-molecules-mycotoxins-and-cytokines-from-whole-blood-using-cytosorb%C3%A2-sorbent-porous-polymer-beads
#5
Maryann C Gruda, Karl-Gustav Ruggeberg, Pamela O'Sullivan, Tamaz Guliashvili, Andrew R Scheirer, Thomas D Golobish, Vincent J Capponi, Phillip P Chan
OBJECTIVE: Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. In sepsis and septic shock, pathogen-associated molecular pattern molecules (PAMPS), such as bacterial exotoxins, cause direct cellular damage and/or trigger an immune response in the host often leading to excessive cytokine production, a maladaptive systemic inflammatory response syndrome response (SIRS), and tissue damage that releases DAMPs, such as activated complement and HMGB-1, into the bloodstream causing further organ injury...
2018: PloS One
https://www.readbyqxmd.com/read/29331425/low-picomolar-label-free-procalcitonin-analytical-detection-with-an-electrolyte-gated-organic-field-effect-transistor-based-electronic-immunosensor
#6
Preethi Seshadri, Kyriaki Manoli, Nicole Schneiderhan-Marra, Uwe Anthes, Piotr Wierzchowiec, Klaus Bonrad, Cinzia Di Franco, Luisa Torsi
Herein a label-free immunosensor based on electrolyte-gated organic field-effect transistor (EGOFET) was developed for the detection of procalcitonin (PCT), a sepsis marker. Antibodies specific to PCT were immobilized on the poly-3-hexylthiophene (P3HT) organic semiconductor surface through direct physical adsorption followed by a post-treatment with bovine serum albumin (BSA) which served as the blocking agent to prevent non-specific adsorption. Antibodies together with BSA (forming the whole biorecognition layer) served to selectively capture the procalcitonin target analyte...
May 1, 2018: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/29207229/-bilirubin-removal-with-coupled-plasma-filtration-and-adsorption-in-patients-affected-by-hilar-cholangiocarcinoma
#7
Walter De Simone, Francesco Crafa, Adele Noviello, Francesco Esposito, Bruno Zito, Rocco Manganelli, Antonella De Simone, Luigi Covotta, Giuseppe Palladino, Emanuele De Simone
Background: Patients affected by hilar cholangiocarcinoma are eligible for surgery only in the 20-30% of the cases and postoperative mortality is 40-50%. Many specialists are involved in the treatment of this disease, like surgeons, gastroenterologists, oncologists and radiotherapists. Recent studies have shown that preoperative bilirubinaemia is a predictor of morbidity and mortality after surgery. Coupled Plasma Filtration and Adsorption (CPFA) is a blood purification extracorporeal therapy recommended for sepsis and able to reduce bilirubinaemia...
December 5, 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28991050/selective-lps-adsorption-using-polymyxin-b-immobilized-fiber-cartridges-in-sepsis-patients-following-cardiac-surgery
#8
Michael Yaroustovsky, Marina Abramyan, Ekaterina Komardina, Helen Nazarova, Dmitrii Popov, Marina Plyushch, Alina Soldatkina, Ekaterina Rogalskaya
Sepsis remains the leading cause of morbidity and mortality in intensive care units. The extracorporeal therapy in the complex treatment of sepsis seems to be the most promising direction.The aim of this study was to assess the safety and effectiveness of selective endotoxin adsorption on the basis of the analysis of our own experience with the intensive therapy for sepsis in adult cardiac surgical patients. MATERIALS AND METHODS: Our single-center study included 143 patients with sepsis...
October 4, 2017: Shock
https://www.readbyqxmd.com/read/28931287/enhanced-capture-of-bacteria-and-endotoxin-by-antimicrobial-wlbu2-peptide-tethered-on-polyethylene-oxide-spacers
#9
Ramya Raman, Miranda A Raper, Erik Hahn, Kate F Schilke
Severe sepsis is a life threatening immune response that may be caused by endotoxins (lipopolysaccharides) in circulating bacterial cell wall fragments. Hemoperfusion through a sorbent column coated with the antimicrobial peptide polymyxin B (PMB) is a promising treatment for sepsis. However, PMB is cytotoxic and neurotoxic, and is a membrane disruptor that may fragment endotoxin vesicles. In addition, the blood is not protected from nonspecific interactions with the synthetic surface of the solid support. These effects may be responsible for the variety of undesirable clinical outcomes, including nonspecific adsorption of proteins, blood cell damage, platelet activation, and a lack of clear evidence of efficacy of the current hemoperfusion products...
September 20, 2017: Biointerphases
https://www.readbyqxmd.com/read/28923774/endotoxin-adsorption-direct-hemoperfusion-with-the-polymyxin-b-immobilized-fiber-column-pmx
#10
REVIEW
Tomoharu Shimizu, Toru Miyake, Naomi Kitamura, Masaji Tani, Yoshihiro Endo
Toraymyxin® is a medical device developed to adsorb circulating endotoxins in the blood using direct hemoperfusion therapy for patients with septic shock. In 1994, the Japanese National Health Insurance system approved the use of Toraymyxin for the treatment of endotoxemia and septic shock. Since then, Toraymyxin has been safely used in more than 100,000 cases in emergency and intensive care units in Japan. Toraymyxin is currently available for use in the clinical setting in 14 countries worldwide. In this study, we reviewed and introduced the development, clinical use, and efficacy of Toraymyxin and commented on its anticoagulant use and cartridge clotting issue in the treatment of severe sepsis and septic shock...
October 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28894043/immune-disorders-in-sepsis-and-their-treatment-as-a-significant-problem-of-modern-intensive-care
#11
Lidia Łysenko, Patrycja Leśnik, Kamil Nelke, Hanna Gerber
Despite the great advances in the treatment of sepsis over the past 20 years, sepsis remains the main cause of death in intensive care units. In the context of new possibilities of treating sepsis, a comprehensive response of the immune system to the infection, immunosuppression, in particular, has in recent years gained considerable interest. There is vast evidence pointing to the correlation between comorbid immunosuppression and an increased risk of recurrent infections and death. Immune disorders may impact the clinical course of sepsis...
August 22, 2017: Postȩpy Higieny i Medycyny Doświadczalnej
https://www.readbyqxmd.com/read/28589286/extracorporeal-cytokine-elimination-as-rescue-therapy-in-refractory-septic-shock-a-prospective-single-center-study
#12
Sigrun Friesecke, Stephanie-Susanne Stecher, Stefan Gross, Stephan B Felix, Axel Nierhaus
Sepsis is the most common cause of death in medical intensive care units (ICU). If sepsis progresses to refractory septic shock, mortality may reach 90-100% despite optimum current therapy. Extracorporeal cytokine adsorption in addition to regular therapy was studied prospectively in refractory septic shock patients on a medical ICU. Refractory shock was defined as increasing vasopressor dose required to maintain mean arterial blood pressure above 65 mmHg or increasing lactate levels despite protocol-guided shock therapy for 6 h...
September 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28535518/extracorporeal-sorbent-technologies-basic-concepts-and-clinical-application
#13
REVIEW
William R Clark, Fiorenza Ferrari, Gaetano La Manna, Claudio Ronco
Limitations imposed by the characteristics of some solutes and the structure of dialysis membranes have spurred new interest in the use of mechanisms beyond diffusion and convection for extracorporeal solute removal. Sorbents have been utilized for more than 50 years in extracorporeal blood treatments for specific purposes, and better understanding of their basic aspects may further expand the potential for their clinical application. In this chapter, the basic principles applying to sorbents are discussed, including composition and structure, along with the fundamental mechanisms of solute removal...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28535517/coupled-plasma-filtration-adsorption-application-for-liver-and-thyroid-toxins
#14
Gabriele Donati, Irene Capelli, Anna Laura Croci Chiocchini, Nicolò Natali, Anna Scrivo, Gaetano La Manna
Coupled plasma filtration and adsorption (CPFA) is a detoxification system that combines a plasma adsorption circuit and a continuous renal replacement therapy circuit. Its main application is for sepsis and septic shock with or without acute renal failure. Several recent studies have suggested that CPFA can reduce the mortality when the volume of plasma absorbed on the styrenic resin is at least >0.18 L/kg/day. At present, new applications for CPFA are under investigation, also in patients without significant kidney failure...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28525674/continuous-hemoadsorption-with-a-cytokine-adsorber-during-sepsis-a-review-of-the-literature
#15
REVIEW
Khosrow S Houschyar, Malcolm N Pyles, Susanne Rein, Ina Nietzschmann, Dominik Duscher, Zeshaan N Maan, Kristian Weissenberg, Hubertus M Philipps, Catharina Strauss, Beate Reichelt, Frank Siemers
Sepsis is a well-recognized healthcare issue worldwide, ultimately resulting in significant mortality, morbidity and resource utilization during and after critical illness. In its most severe form, sepsis causes multi-organ dysfunction that produces a state of critical illness characterized by severe immune dysfunction and catabolism. Sepsis induces the activation of complement factor via 3 pathways and the release of inflammatory cytokines such as tumor necrosis factor alpha (TNF-α) and interleukin-1beta (IL-1β), resulting in a systemic inflammatory response...
May 29, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28358803/efficacy-of-polymyxin-b-immobilized-fiber-hemoperfusion-for-patients-with-septic-shock-caused-by-gram-negative-bacillus-infection
#16
Nobuyuki Saito, Kazuhiro Sugiyama, Testu Ohnuma, Takashi Kanemura, Michitaka Nasu, Yuya Yoshidomi, Yuta Tsujimoto, Hiroshi Adachi, Hiroyuki Koami, Aito Tochiki, Kota Hori, Yukiko Wagatsuma, Hisashi Matsumoto
Septic shock-associated mortality in intensive care units (ICUs) remains high, with reported rates ranging 30-50%. In particular, Gram-negative bacilli (GNB), which induce significant inflammation and consequent multiple organ failure, are the etiological bacterial agent in 40% of severe sepsis cases. Hemoperfusion using polymyxin B-immobilized fiber (PMX), which adsorbs endotoxin, is expected to reduce the inflammatory sepsis cascade due to GNB. However, the clinical efficacy of this treatment has not yet been demonstrated...
2017: PloS One
https://www.readbyqxmd.com/read/28342161/granulocyte-and-monocyte-adsorptive-apheresis-ameliorates-sepsis-in-rats
#17
Shuai Ma, Qingqing Xu, Bo Deng, Yin Zheng, Hongyan Tian, Li Wang, Feng Ding
BACKGROUND: Overwhelming activation of granulocytes and monocytes is central to inflammatory responses during sepsis. Granulocyte and monocyte adsorptive apheresis (GMA) is an extracorporeal leukocyte apheresis device filled with cellulose acetate beads and selectively adsorbs granulocytes and monocytes from the peripheral blood. METHODS: In this study, septic rats received the GMA treatment for 2 h at 18 h after cecal ligation and puncture. RESULTS: GMA selectively adsorbed activated neutrophils and monocytes from the peripheral blood, reduced serum inflammatory cytokine expression, and seemed to improve organ injuries and animal survival...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28165586/efficacy-of-postoperative-polymyxin-b-hemoperfusion-in-secondary-peritonitis-patients-with-septic-shock-a-propensity-matched-analysis
#18
Kuo-Ching Yuan, Shang-Yu Wang, Ming-Chin Yu, Yu-Pao Hsu, Heng-Chih Pan, Yung-Chang Chen
INTRODUCTION: Severe sepsis and septic shock is still a challenge. Polymyxin B hemoperfusion (PMX) is a device designed to remove circulating endotoxin by adsorption, which is reported to improve treatment outcomes. This study aimed to further verify the efficacy of PMX on postoperative, peritonitis, septic shock patients. METHODS: This study prospectively analyzed 20 of 155 patients who presented with postoperative septic shock and were treated with PMX in a single institute during the period March 2013 to September 2014 (Clinical Trial Protocol number: ChiCTR-ONC-16008160)...
February 10, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/27931259/abdominal-septic-shock-endotoxin-adsorption-treatment-asset-endotoxin-removal-in-abdominal-and-urogenital-septic-shock-with-the-alteco%C3%A2-lps-adsorber-study-protocol-for-a-double-blinded-randomized-placebo-controlled-trial
#19
RANDOMIZED CONTROLLED TRIAL
Miklos Lipcsey, Jyrki Tenhunen, Jan Sjölin, Robert Frithiof, Stepani Bendel, Hans Flaatten, Rafael Kawati, Anne Kuitunen, Tor Inge Tønnessen, Sten Rubertsson
BACKGROUND: Severe sepsis and septic shock are common in intensive care and carry high mortality rates. In patients with Gram-negative infections, early and extensive removal of endotoxin may limit the inflammatory response that characterizes septic shock. The Alteco® LPS Adsorber (hereafter referred to cited as the lipopolysaccharide (LPS) Adsorber) can be used for endotoxin removal and attenuate the deleterious inflammatory and clinical responses seen in septic shock. METHODS/DESIGN: The Abdominal Septic Shock - Endotoxin Adsorption Treatment (ASSET) trial is a pilot study investigating the feasibility and safety of LPS Adsorber therapy...
December 8, 2016: Trials
https://www.readbyqxmd.com/read/27768920/nano-lc-ms-ms-for-the-identification-of-proteins-trapped-in-sorbent-cartridges-used-for-coupled-plasma-filtration-adsorption-treatments-of-healthy-pigs
#20
Donatella Nardiello, Clelia Prattichizzo, Maria Teresa Rocchetti, Loreto Gesualdo, Diego Centonze
A dedicated proteomic approach based on nano-Liquid Chromatography coupled with tandem mass spectrometry in ion trap is proposed for the analysis of proteins trapped in sorbent resin cartridges used to remove inflammatory mediators from blood by coupled plasma filtration adsorption (CPFA). The final purpose of the proposed proteomic approach was to obtain a reference map of plasma proteins trapped in CPFA sorbents used for the extracorporeal blood purification of healthy pigs, with the potential impact to design new bio-filters able to control the inflammatory imbalance under pathological conditions, such as severe sepsis...
January 5, 2017: Journal of Pharmaceutical and Biomedical Analysis
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