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adsorption AND Sepsis

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https://www.readbyqxmd.com/read/28589286/extracorporeal-cytokine-elimination-as-rescue-therapy-in-refractory-septic-shock-a-prospective-single-center-study
#1
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...
June 6, 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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/27764982/development-of-nanosponges-from-erythrocyte-ghosts-for-removal-of-streptolysin-o-from-mammalian-blood
#10
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
https://www.readbyqxmd.com/read/27760529/the-effect-of-continuous-venovenous-hemofiltration-on-neutrophil-gelatinase-associated-lipocalin-plasma-levels-in-patients-with-septic-acute-kidney-injury
#11
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
https://www.readbyqxmd.com/read/27503310/polystyrene-divinylbenzene-based-adsorbents-reduce-endothelial-activation-and-monocyte-adhesion-under-septic-conditions-in-a-pore-size-dependent-manner
#12
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
https://www.readbyqxmd.com/read/27436098/combination-of-ecmo-and-cytokine-adsorption-therapy-for-severe-sepsis-with-cardiogenic-shock-and-ards-due-to-panton-valentine-leukocidin-positive-staphylococcus-aureus-pneumonia-and-h1n1
#13
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
https://www.readbyqxmd.com/read/27406647/mortality-reduction-in-septic-shock-by-plasma-adsorption-rompa-a-protocol-for-a-randomised-clinical-trial
#14
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
https://www.readbyqxmd.com/read/27029079/-the-new-concept-of-combined-use-of-extracorporeal-blood-correction-in-complex-intensive-therapy-of-severe-sepsis-in-patients-after-cardiac-surgery
#15
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
https://www.readbyqxmd.com/read/27012053/the-superiority-of-an69st-membrane-in-the-adsorption-of-fibroblast-growth-factor-23
#16
COMPARATIVE STUDY
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
https://www.readbyqxmd.com/read/26852583/-influence-of-extracorporeal-detoxification-methods-on-tissue-perfusion-in-septic-shock
#17
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
https://www.readbyqxmd.com/read/26657106/application-of-continuous-renal-replacement-therapy-what-should-we-consider-based-on-existing-evidence
#18
REVIEW
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
https://www.readbyqxmd.com/read/26627603/adsorption-of-histones-on-natural-polysaccharides-the-potential-as-agent-for-multiple-organ-failure-in-sepsis
#19
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
https://www.readbyqxmd.com/read/26621809/coupled-plasma-haemofiltration-filtration-in-severe-sepsis-systematic-review-and-meta-analysis
#20
REVIEW
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
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