title: [Plasma exchange in treatment refractory septic shock : Presentation of a therapeutic add-on strategy].
abstract: Sepsis is defined as a systemic inflammatory response of the body to an infection. Besides anti-infective drugs and removal of the site of infection, no specific therapeutics that target the overwhelming host response are available. Clinical researchers are currently evaluating the extracorporeal elimination of circulating cytokines. Modern adsorbing techniques have increasingly been used for this purpose allowing an unselective but highly effective removal of the vast majority of circulating cytokines but also fail to replace used protective factors in patients' plasma. Therapeutic plasma exchange (TPE) however might represent a novel method to remove pathologically elevated cytokines and simultaneously to replace protective plasmatic factors. Here we report the case of a septic shock patient treated with TPE and review the available literature with respect to TPE as an adjunctive therapy in sepsis.
authors.affiliation: Klinik für Nieren- und Hochdruckerkrankungen, Zentrum Innere Medizin, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland. david.sascha@mh-hannover.de.
authors.forename: S
authors.initials: S
authors.lastname: David
authors.affiliation: Klinik für Pneumologie, Zentrum Innere Medizin, Medizinische Hochschule Hannover, Hannover, Deutschland.
authors.forename: M M
authors.initials: MM
authors.lastname: Hoeper
authors.affiliation: Klinik für Nieren- und Hochdruckerkrankungen, Zentrum Innere Medizin, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
authors.forename: J T
authors.initials: JT
authors.lastname: Kielstein
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003422:Critical Care / Q000379:methods; D016207:Cytokines / Q000097:blood; D024901:Drug Resistance, Multiple, Bacterial; D004927:Escherichia coli Infections / Q000276:immunology / Q000628:therapy; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000008:administration & dosage / Q000097:blood; D010951:Plasma Exchange / Q000379:methods*; D010956:Plasmapheresis / Q000379:methods; D011183:Postoperative Complications / Q000276:immunology / Q000628:therapy; D012772:Shock, Septic / Q000276:immunology / Q000628:therapy*; D014552:Urinary Tract Infections / Q000276:immunology / Q000628:therapy; D055986:Vital Signs
chemical_list: D000900:Anti-Bacterial Agents; D016207:Cytokines; D018836:Inflammation Mediators; D009638:Norepinephrine
keywords: Cytokines; Disseminated intravascular coagulation; Infection; Plasmapheresis; Systemic inflammatory response syndrome