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adsorption AND Sepsis

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 4, 2017: International Journal of Artificial Organs
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
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
Vikesh Chhabria, Steve Beeton
AIM: To produce mammalian biomimetic nanosponges from mammalian erythrocyte ghosts. Biomimetic nanosponges were studied in vitro as treatment platforms against exotoxin-related sepsis. METHODS: Ovine blood was treated with hypotonic buffer to create erythrocyte ghosts and then subjected to sonication to produce erythrocyte vesicles of nonuniform size. Vesicles were then serially extruded through 400-nm and 100-nm polycarbonate membranes. Nanosponges were prepared by fusing poly(d,l-lactic-co-glycolic acid) cores with ovine erythrocyte vesicles...
October 21, 2016: Nanomedicine
Xingui Dai, Tao Li, Zhenhua Zeng, Chunlai Fu, Shengbiao Wang, Yeping Cai, Zhongqing Chen
BACKGROUND: It is known that continuous venonenous hemofiltration (CVVH) does not affect the plasma level of neutrophil gelatinase-associated lipocalin (pNGAL) in acute kidney injury (AKI) patients. However, because of the unique pathophysiology underlying AKI caused by sepsis, the effect of CVVH on pNGAL in this clinical setting is less certain. The purpose of this study was to determine the effect of CVVH on pNGAL in sepsis-induced AKI patients. METHODS: Between August 1, 2014, and December 31, 2014, 42 patients with sepsis-induced AKI underwent CVVH in the general intensive care unit of our institution and were consecutively enrolled in this study...
October 19, 2016: BMC Nephrology
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...
December 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...
July 12, 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
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