Plasma adsorption in critical care.
Plasmapheresis therapies such as plasma exchange (PE), double filtration plasmapheresis (DFPP), or immunoadsorption plasmapheresis (IAPP) have become therapeutic tools in critical care. PE or DFPP are limited by their non- or semiselective removal of all plasma components. Replacement fluids such as fresh frozen plasma and albumin are necessary during PE or DFPP. There is the risk of infection and allergic reactions whenever such fluids are used. On the other hand, IAPP is superior to PE and DFPP because it does not require any replacement fluid. There has been development of many adsorbent columns used for removing specific pathogenic substances, and patients with various kinds of critical illness have been treated with IAPP. However, IAPP can be applied only for certain diseases because of the limitations of the commercially available columns. It is concluded that the development of new adsorption therapy may improve the high mortality and morbidity rate in critically ill patients.
Department of Internal Medicine and Rheumatology, Juntendo University, Tokyo, Japan.
Kwang-Seok
KS
Yang
Kazuo
K
Kenpe
Ken
K
Yamaji
Hiroshi
H
Tsuda
Hiroshi
H
Hashimoto
D000017:ABO Blood-Group System; D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000097:blood; D016736:Antiphospholipid Syndrome / Q000628:therapy; D001787:Blood Group Incompatibility / Q000276:immunology; D003422:Critical Care / Q000379:methods*; D005260:Female; D020275:Guillain-Barre Syndrome / Q000628:therapy; D006801:Humans; D007163:Immunosorbent Techniques; D016030:Kidney Transplantation; D009157:Myasthenia Gravis / Q000628:therapy; D010956:Plasmapheresis / Q000379:methods*; D011247:Pregnancy
D000017:ABO Blood-Group System; D017153:Antibodies, Anticardiolipin