title: The future of extracorporeal support.
abstract: Extracorporeal therapy has expanded significantly over the past few decades from solely artificial renal replacement therapy. In patients with multiple organ dysfunction syndrome, it becomes necessary to provide multiple organ support therapy. Technological advances have opened the door to a multifaceted intervention directed at supporting the function of multiple organs through the treatment of blood. Indications for "old" therapies such as hemofiltration and adsorption have been expanded, and using these therapies in combination further enhances blood detoxification capabilities. Furthermore, new devices are constantly in development. Nanotechnology allows us to refine membrane characteristics and design innovative monitoring/biofeedback devices. Miniaturization is leading down the path of wearable/implantable devices. With the incorporation of viable cells within medical devices, these instruments become capable not only of detoxification but synthetic functions as well, bringing us closer to the holy grail of complete replacement of organ function. This article provides a brief overview of current and future direction in extracorporeal support in the critical care setting.
authors.affiliation: Department of Nephrology, Ospedale San Bortolo, and International Renal Research Institute Vicenza, Vicenza, Italy.
authors.forename: Dinna
authors.initials: D
authors.lastname: Cruz
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Bellomo
authors.forename: John A
authors.initials: JA
authors.lastname: Kellum
authors.forename: Massimo
authors.initials: M
authors.lastname: de Cal
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
mesh_terms: D058186:Acute Kidney Injury / Q000628:therapy*; D001187:Artificial Organs / Q000639:trends*; D003422:Critical Care / Q000379:methods* / Q000639:trends; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods / Q000639:trends; D006464:Hemoperfusion / Q000379:methods* / Q000639:trends; D006801:Humans; D036103:Nanotechnology / Q000379:methods* / Q000639:trends; D006435:Renal Dialysis / Q000379:methods* / Q000639:trends