PMID: 18203064Jan 19, 2008Paper

High cut-off point membranes in septic acute renal failure: a systematic review

The International Journal of Artificial Organs
Michael HaaseN Boyce

Abstract

To review the literature on the experimental, physiological and clinical effects of blood purification with high cut-off (HCO) point membranes in septic acute renal failure (ARF). MEDLINE and PubMed database search combining relevant terms and integrating data from studies on the use of HCO membranes. Ex vivo studies of endotoxemia, animal studies of bacteremia and clinical studies using HCO membranes in patients with septic ARF. Original data from primary publications. HCO membrane-based hemodialysis, hemodiafiltration or hemofiltration. Plasma cytokine clearance, immunological and physiological effects and safety parameters of HCO membranes. HCO membranes effectively remove cytokines from blood. Treatment using HCO membranes has beneficial effects on immune cell function and increases survival in animal models of sepsis. Preliminary clinical studies show that HCO membranes decrease plasma cytokine levels and the need for vasopressor therapy. HCO membrane-based blood purification has now been applied in four pilot randomized controlled studies of 70 patients with septic ARF with no reports of serious adverse effects. Because of substantial heterogeneity, no formal quantitative analysis could be performed. The available evidenc...Continue Reading

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