title: Techniques of extracorporeal cytokine removal: a systematic review of the literature on animal experimental studies.
abstract: OBJECTIVE
  Extracorporeal cytokine removal may be desirable. We sought to assess extracorporeal blood purification (EBP) techniques for cytokine removal in experimental animal studies.
  
  
  METHODS
  We conducted a targeted, systematic search and identified 17 articles. We analyzed cytokine clearance, sieving coefficient (SC), ultrafiltrate (UF) concentration, and percentage removal. As this review concerns technical appraisal of EBP techniques, we made no attempts to appraise the methodology of the studies included. Results are in descriptive terms only.
  
  
  RESULTS
  Applying predicted clearance for 80 kg human, high volume hemofiltration (HVHF) techniques and plasmafiltration (PF) showed the highest rates of cytokine removal. High cutoff (HCO)/HF and PF techniques showed modest ability to clear cytokines using low to medium flows. Standard hemofiltration had little efficacy. At higher flows, HCO/HF achieved clearances between 30 and 70 ml/min for IL-6 and IL-10. There was essentially no removal of tumor necrosis factor (TNF)-alpha outside of PF.
  
  
  CONCLUSIONS
  Experimental animal studies indicate that HVHF (especially with HCO filters) and plasmafiltration have the potential to achieve appreciable IL-6 and IL-10 clearances. However, only PF can remove TNF-alpha reliably.
authors: Johor Bahru Clinical School, Monash University Sunway Campus, Bukit Azah, Johor Bahru, Johor, Malaysia.
authors: Rafidah
authors: R
authors: Atan
authors: David
authors: D
authors: Crosbie
authors: Rinaldo
authors: R
authors: Bellomo
mesh_terms: D000818:Animals; D016207:Cytokines / Q000097:blood*; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008567:Membranes, Artificial; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D016207:Cytokines; D015850:Interleukin-6; D008567:Membranes, Artificial; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10