title: Cytokine removal by plasma exchange with continuous hemodiafiltration in critically ill patients.
abstract: The effectiveness of plasma exchange (PE) with continuous hemodiafiltration (CHDF) in the treatment of critically ill patients was evaluated based on changes in cytokine levels. Twenty-six patients with acute hepatic failure were treated with PE (PE group) or PE and CHDF (PE+CHDF group), and the levels of cytokines such as tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, and IL-8 were determined before and after treatment. Bilirubin levels were significantly lower after treatment in both the PE and PE+CHDF groups. There were no significant differences in TNF-alpha levels before and after treatment in the PE group, but the TNF-alpha level was significantly lower after treatment in the PE+CHDF group. There were no significant differences in the IL-6 levels before and after treatment in both the PE and PE+CHDF groups. There were no significant differences in IL-8 levels before and after treatment in the PE group, but the IL-8 level was significantly lower after treatment in the PE+CHDF group. PE with CHDF therapy was given to 5 patients with acutely aggravated autoimmune diseases, 2 patients with hemorrhagic shock and encephalopathy syndrome, and 3 patients with thrombotic microangiopathy. The results suggested that PE with CHDF therapy are useful in critically ill patients with suspected hypercytokinemia.
authors.affiliation: Department of Emergency and Critical Care Medicine, Akita University School of Medicine, Akita, Japan. nakaeh@doc.med.akita-u.ac.jp
authors.forename: Hajime
authors.initials: H
authors.lastname: Nakae
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Asanuma
authors.forename: Kimitaka
authors.initials: K
authors.lastname: Tajimi
mesh_terms: D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases / Q000097:blood / Q000628:therapy; D001663:Bilirubin / Q000097:blood; D001778:Blood Coagulation Disorders / Q000097:blood / Q000628:therapy; D016638:Critical Illness / Q000628:therapy*; D016207:Cytokines / Q000097:blood*; D005260:Female; D017583:Hemodiafiltration; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D017114:Liver Failure, Acute / Q000097:blood / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange; D012771:Shock, Hemorrhagic / Q000097:blood / Q000628:therapy; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D016207:Cytokines; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D001663:Bilirubin