[Coupled plasma filtration adsorption: rationale and perspectives in septic shock].
OBJECTIVE
Septic shock is the leading cause of multiple organ failure and mortality in intensive care units. This condition seems to be related to an overproduction of both pro- and anti-inflammatory mediators, leading to an immunological dysfunction. Therapeutic strategies aimed at reducing blood and tissue concentrations of these mediators have been developed. One of these techniques, based on extra-renal filtration, is called "coupled plasma filtration and adsorption".


METHODS
English and French language articles published between 1984 and 2008 were identified through a computerized Medline search. Keywords and MeSH terms used were: "coupled plasmafiltration", "coupled plasma filtration", "adsorption", "blood purification", "cytokines", "hemofiltration", "sepsis". Relevant publications were retrieved and scanned for additional sources. Nine publications were found.


RESULTS
Coupled plasma filtration adsorption is an extra-corporeal treatment, based on non-specific cytokine adsorption on a specially designed resin cartridge, coupled with hemofiltration. Experimental studies and the first clinical trials have shown interesting results regarding hemodynamics and respiratory parameters. However, these trials failed to demonstrate any improvement in outcome.


CONCLUSIONS
Additional evidence is needed to clarify the role of this blood purification technique for the treatment of septic shock.
Page
Mathieu
M
Département d'anesthésie réanimation, pavillon P réanimation, Hôpital Edouard Herriot, 5 place d'Arsonval, 69437 Lyon Cedex 03 France. page.mat@gmail.com
Rimmelé
Thomas
T
D000327:Adsorption / Q000276:immunology; D000818:Animals; D016207:Cytokines / Q000737:chemistry / Q000276:immunology; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D018836:Inflammation Mediators / Q000737:chemistry; D016032:Randomized Controlled Trials as Topic; D012772:Shock, Septic / Q000276:immunology* / Q000628:therapy*
D016207:Cytokines; D018836:Inflammation Mediators