Hemopurification in sepsis: current view

Česká verzia

Authors: R. Sýkora; J. Chvojka; A. Kroužecký; J. Raděj; T. Karvunidis; I. Novák; M. Matějovič
Authors place of work: Jednotka intenzivní péče I. interní kliniky Lékařské fakulty UK a FN Plzeň, přednosta doc. MUDr. Martin Matějovič, Ph. D.
Published in the journal: Vnitř Lék 2008; 54(10): 1000-1005
Category: Reviews

Summary

Sepsis is the leading cause of mortality in non‑coronary intensive care units. The uncontrolled and deregulated systemic inflammatory response to infection plays a central role in the pathophysiology of sepsis. This response is mediated by a broad spectrum of endogenous mediators leading to dysfunction in multiple organs remote from the primary infectious site. The failure of numerous clinical trials aimed at eliminating a single mediator stimulated the research to focus on non‑selective removal of excessively produced mediators of sepsis. This “detoxification” forms the theoretical basis and biological rationale for the use of hemopurification therapies as an adjunctive treatment of sepsis. Our article reviews the current evidence of hemopurification methods in the supportive treatment of sepsis, briefly discusses new trends and summarizes the recommendations for clinical practice.

Key words:
sepsis – septic shock – hemofiltration – high volume hemofiltration – hemopurification methods

Zdroje

1. Uchino S, Bellomo R, Morimatsu H et al. Continuous renal replacement therapy: a worldwide practice survey. The beginning and ending supportive therapy for the kidney (B.E.S.T. kidney) investigators. Intensive Care Med 2007; 33: 1563–1570.

2. Honore PM, Joannes-Boyau O, Gressens B. Blood and plasma treatments: the rationale of high-volume hemofiltration. Contrib Nephrol 2007; 156: 387–395.

3. Bouman CS, Oudemans-van Straaten HM, Schultz MJ et al. Hemofiltration in sepsis and systemic inflammatory response syndrome: the role of dosing and timing. J Crit Care 2007; 22: 1–12.

4. Ronco C, Bellomo R, Homel P et al. Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure: a prospective randomised trial. Lancet 2000; 356: 26–30.

5. Cole L, Bellomo R, Journois D et al. High-volume haemofiltration in human septic shock. Intensive Care Med 2001; 27: 978–986.

6. Honore PM, Jamez J, Wauthier M et al. Prospective evaluation of short‑term, high-volume isovolemic hemofiltration on the hemodynamic course and outcome in patients with intractable circulatory failure resulting from septic shock. Crit Care Med 2000; 28: 3581–3587.

7. Ratanarat R, Brendolan A, Piccinni P et al. Pulse high-volume haemofiltration for treatment of severe sepsis: effects on hemodynamics and survival. Crit Care 2005; 9: R294–R302.

8. Oudemans-van Straaten HM, Bosman RJ, van der Spoel JI et al. Outcome of critically ill patients treated with intermittent high-volume haemofiltration: a prospective cohort analysis. Intensive Care Med 1999; 25: 814–821.

9. JoannesBoyau O, Rapaport S, Bazin R et al. Impact of high volume hemofiltration on hemodynamic disturbance and outcome during septic shock. ASAIO J 2004; 50: 102–109.

10. Piccinni P, Dan M, Barbacini S et al. Early isovolaemic haemofiltration in oliguric patients with septic shock. Intensive Care Med 2006; 32: 80–86.

11. Cornejo R, Downey P, Castro R et al. High-volume hemofiltration as salvage therapy in severe hyperdynamic septic shock. Intensive Care Med 2006; 32: 713–722.

12. Grootendorst AF, van Bommel EF, van der HB et al. High volume hemofiltration improves right ventricular function in endotoxin‑induced shock in the pig. Intensive Care Med 1992; 18: 235–240.

13. Ullrich R, Roeder G, Lorber C et al. Continuous venovenous hemofiltration improves arterial oxygenation in endotoxin‑induced lung injury in pigs. Anesthesiology 2001; 95: 428–436.

14. Yekebas EF, Eisenberger CF, Ohnesorge H et al. Attenuation of sepsis‑related immunoparalysis by continuous veno-venous hemofiltration in experimental porcine pancreatitis. Crit Care Med 2001; 29: 1423–1430.

15. Bellomo R, Kellum JA, Gandhi CR et al. The effect of intensive plasma water exchange by hemofiltration on hemodynamics and soluble mediators in canine endotoxemia. Am J Respir Crit Care Med 2000; 161: 1429–1436.

16. Rogiers P, Zhang H, Smail N et al. Continuous venovenous hemofiltration improves cardiac performance by mechanisms other than tumor necrosis factor‑alpha attenuation during endotoxic shock. Crit Care Med 1999; 27: 1848–1855.

17. Cruz D, Bellomo R, Kellum JA et al. The future of extracorporeal support. Crit Care Med 2008; 36: S243–S252.

18. Ronco C, Tetta C. Extracorporal blood purification: more than diffusion and convection. Does this help? Curr Opin Crit Care 2007; 13: 662–667.

19. De Vriese AS. Prevention and treatment of acute renal failure in sepsis. J Am Soc Nephrol 2003; 14: 792–805.

20. Ronco C. The immunomodulatory effect of extracorporeal therapies in sepsis: a reconciliation of three theories. Int J Artif Organs 2007; 30: 855–857.

21. Ronco C, Bonello M, Bordoni V et al. Extracorporeal therapies in non‑renal disease: treatment of sepsis and the peak concentration hypothesis. Blood Purif 2004; 22: 164–174.

22. Honore PM, Matson JR. Extracorporeal removal for sepsis: Acting at the tissue level – the beginning of a new era for this treatment modality in septic shock. Crit Care Med 2004; 32: 896–897.

23. Di Carlo JV, Alexander SR. Hemofiltration for cytokine-driven illnesses: the mediator delivery hypothesis. Int J Artif Organs 2005; 28: 777–786.

24. Venkataraman R, Subramanian S, Kellum JA. Clinical review: extracorporeal blood purification in severe sepsis. Crit Care 2003; 7: 139–145.

25. De Vriese AS, Colardyn FA, Philippe JJ et al. Cytokine removal during continuous hemofiltration in septic patients. J Am Soc Nephrol 1999; 10: 846–853.

26. Bouman CS, Oudemans-van Straaten HM, Tijssen JG et al. Effects of early high-volume continuous venovenous hemofiltration on survival and recovery of renal function in intensive care patients with acute renal failure: a prospective, randomized trial. Crit Care Med 2002; 30: 2205–2211.

27. Lee PA, Weger GW, Pryor RW et al. Effects of filter pore size on efficacy of continuous arteriovenous hemofiltration therapy for Staphylococcus aureus‑induced septicemia in immature swine. Crit Care Med 1998; 26: 730–737.

28. Rogiers P, Zhang H, Pauwels D et al. Comparison of polyacrylonitrile (AN69) and polysulphone membrane during hemofiltration in canine endotoxic shock. Crit Care Med 2003; 31: 1219–1225.

29. Yekebas EF, Strate T, Zolmajd S et al. Impact of different modalities of continuous venovenous hemofiltration on sepsis‑induced alterations in experimental pancreatitis. Kidney Int 2002; 62: 1806–1818.

30. Dellinger RP, Levy MM, Carlet JM et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med 2008; 36: 296–327.

31. Cole L, Bellomo R, Hart G et al. A phase II randomized, controlled trial of continuous hemofiltration in sepsis. Crit Care Med 2002; 30: 100–106.

32. Schiffl H. Daily haemodialysis for acute renal failure. Curr Opin Nephrol Hypertens 2002; 11: 589–592.

33. Saudan P, Niederberger M, De SS et al. Adding a dialysis dose to continuous hemofiltration increases survival in patients with acute renal failure. Kidney Int 2006; 70: 1312–1317.

34. Tolwani AJ, Campbell RC, Stofan BS et al. Standard versus high‑dose CVVHDF for ICU‑related acute renal failure. J Am Soc Nephrol 2008; 19: 1233–1238.

35. Zarbock A, Singbartl K, Kellum JA. Evidence‑based renal replacement therapy for acute kidney injury. Minerva Anestesiol 2008 [Epub ahead of print].

36. Ronco C. Renal replacement therapy for acute kidney injury: let‘s follow the evidence. Int J Artif Organs 2007; 30: 89–94.

37. The VA/NIH Acute Renal Failure Trial Network. Intensity of Renal Support in Critically Ill Patients with Acute Kidney Injury. N Engl J Med 2008; 359: 7–20.

38. Schiffl H, Lang SM, Fischer R. Daily hemodialysis and the outcome of acute renal failure. N Engl J Med 2002; 46: 05–310.

39. Ratanarat R, Brendolan A, Ricci Z et al. Pulse high-volume hemofiltration in critically ill patients: a new approach for patients with septic shock. Semin Dial 2006; 19: 69–74.

40. Laurent I, Adrie C, Vinsonneau C et al. High-volume hemofiltration after out-of-hospital cardiac arrest: a randomized study. J Am Coll Cardiol 2005; 46: 432–437.

41. Jiang HL, Xue WJ, Li DQ et al. Influence of continuous veno-venous hemofiltration on the course of acute pancreatitis. World J Gastroenterol 2005; 11: 4815–4821.

42. Matson JR, Zydney RL, Honore PM. Impact of high volume haemofiltration in early septic shock with acute renal injury: A prospective randomized study. Presented at the 18th Annual Congress of ESICM Society. Berlin 2004.

43. Morgera S, Haase M, Rocktaschel J et al. Intermittent high-permeability hemofiltration modulates inflammatory response in septic patients with multiorgan failure. Nephron Clin Pract 2003; 94: c75–c80.

44. Morgera S, Haase M, Kuss T et al. Pilot study on the effects of high cutoff hemofiltration on the need for norepinephrine in septic patients with acute renal failure. Crit Care Med 2006; 34: 2099–2104.

45. Morgera S, Slowinski T, Melzer C et al. Renal replacement therapy with high-cutoff hemofilters: Impact of convection and diffusion on cytokine clearances and protein status. Am J Kidney Dis 2004; 43: 444–453.

46. Mariano F, Fonsato V, Lanfranco G et al. Tailoring high-cut‑off membranes and feasible application in sepsis‑associated acute renal failure: in vitro studies. Nephrol Dial Transplant 2005; 20: 1116–1126.

47. Delanaye P, Lambermont B, Dogne JM et al. Confirmation of high cytokine clearance by hemofiltration with a cellulose triacetate membrane with large pores: an in vivo study. Int J Artif Organs 2006; 29: 944–948.

48. Haase M, Bellomo R, Morger S et al. High cut‑off point membranes in septic acute renal failure: a systematic review. Int J Artif Organs 2007; 30: 1031–1041.

49. Hirasawa H, Oda S, Matsuda K. Continuous hemodiafiltration with cytokine-adsorbing hemofilter in the treatment of severe sepsis and septic shock. Contrib Nephrol 2007; 156: 365–370.

50. Pannu N, Klarenbach S, Wiebe N et al. Renal replacement therapy in patients with acute renal failure: a systematic review. JAMA 2008; 299: 793–805.

51. Palevsky PM. Dialysis modality and dos-ing strategy in acute renal failure. Semin Dial 2006; 19: 165–170.

52. Gibney N, Hoste E, Burdmann EA et al. Timing of initiation and discontinuation of renal replacement therapy in AKI: unanswered key questions. Clin J Am Soc Nephrol 2008; 3: 876–880.

53. Bagshaw SM, Berthiaume LR, Delaney A et al. Continuous versus intermittent renal replacement therapy for critically ill patients with acute kidney injury: a meta‑analysis. Crit Care Med 2008; 36: 610–617.

54. Ronco C, Cruz D, Bellomo R. Continuous renal replacement in critical illness. Contrib Nephrol 2007; 156: 309–319.

55. Tolwani AJ, Wheeler TS, Wille KM. Sustained low-efficiency dialysis. Contrib Nephrol 2007; 156: 320–324.

56. Formica M, Inguaggiato P, Bainotti S et al. Coupled plasma filtration adsorption. Contrib Nephrol 2007; 156: 405–410.

57. Saito A, Aung T, Sekiguchi K et al. Present status and perspective of the develop-ment of a bioartificial kidney for chronic renal failure patients. Ther Apher Dial 2006; 10: 342–347.

58. Issa N, Messer J, Paganini EP. Renal assist device and treatment of sepsis‑induced acute kidney injury in intensive care units. Contrib Nephrol 2007; 156: 419–427.