title: Techniques of extracorporeal cytokine removal: a systematic review of the literature.
abstract: OBJECTIVE
  Attempts at achieving cytokine homeostasis include blood purification to deliver cytokine removal. Assessment of ex vivo studies for optimal operating conditions is a vital step.
  
  
  METHODS
  We conducted a systematic search for ex vivo studies on cytokine removal using known modalities of extracorporeal circulation. We selected 29 articles and analyzed data according to clearance, sieving coefficient, ultrafiltrate concentration and percentage removal.
  
  
  RESULTS
  We identified four main techniques for cytokine removal: standard techniques, high cut-off (HCO) techniques, adsorption techniques and combined plasma filtration adsorption. HCO hemofiltration (HCO/HF) showed greatest consistency in cytokine removal among all approaches. Mean albumin clearance with HCO filters was 3.74 ml/min.
  
  
  CONCLUSIONS
  Ex vivo data support the view that HCO/HF is the most consistently effective approach in terms of sieving and clearance. Further investigation of HCO/HF in randomized controlled trials in animal models and humans seems desirable.
authors.affiliation: Department of Intensive Care, Austin Hospital, Heidelberg, Vic., Australia.
authors.forename: Rafidah
authors.initials: R
authors.lastname: Atan
authors.forename: David
authors.initials: D
authors.lastname: Crosbie
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Bellomo
mesh_terms: D000327:Adsorption; D000818:Animals; D016207:Cytokines / Q000097:blood* / Q000302:isolation & purification*; D006440:Hemofiltration / Q000295:instrumentation / Q000379:methods; D006801:Humans; D010951:Plasma Exchange / Q000295:instrumentation / Q000379:methods*; D010956:Plasmapheresis / Q000295:instrumentation / Q000379:methods*; D017582:Renal Replacement Therapy / Q000295:instrumentation / Q000379:methods*
chemical_list: D016207:Cytokines