Treatment of severe sepsis and septic shock by CHDF using a PMMA membrane hemofilter as a cytokine modulator.
It has been reported that various types of blood purification intended for the removal of humoral mediators, such as cytokines, were performed in patients with severe sepsis/septic shock. While high-volume hemofiltration, hemofiltration using high cut-off membrane filters, and direct hemoperfusion with a polymyxin-B immobilized column are widely used in the treatment of severe sepsis/septic shock, we perform continuous hemodiafiltration using a polymethylmethacrylate membrane hemofilter (PMMA-CHDF), which shows an excellent cytokine-adsorbing capacity, for the treatment of severe sepsis/septic shock. In our previous study, it was found that PMMA-CHDF could efficiently remove various pro-inflammatory cytokines such as TNFalpha, IL-6 and IL-8 from the bloodstream, resulting in early recovery from septic shock. Furthermore, PMMA-CHDF could remove anti-inflammatory cytokines such as IL-10 from bloodstream, suggesting that it might improve immunoparalysis as well. These findings suggest that PMMA-CHDF is useful for the treatment of patients with severe sepsis/septic shock as a cytokine modulator.
Nakamura
Masataka
M
Oda
Shigeto
S
Sadahiro
Tomohito
T
Hirayama
Yoh
Y
Watanabe
Eizo
E
Tateishi
Yoshihisa
Y
Nakada
Taka-Aki
TA
Hirasawa
Hiroyuki
H
D016207:Cytokines / Q000097:blood / Q000302:isolation & purification*; D017583:Hemodiafiltration / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D016753:Interleukin-10 / Q000097:blood / Q000302:isolation & purification; D015850:Interleukin-6 / Q000097:blood / Q000302:isolation & purification; D016209:Interleukin-8 / Q000097:blood / Q000302:isolation & purification; D008567:Membranes, Artificial; D019904:Polymethyl Methacrylate; D018805:Sepsis / Q000628:therapy*; D012772:Shock, Septic / Q000628:therapy*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood / Q000302:isolation & purification
D016207:Cytokines; D015850:Interleukin-6; D016209:Interleukin-8; D008567:Membranes, Artificial; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D019904:Polymethyl Methacrylate