Comparison of polyacrylonitrile (AN69) and polysulphone membrane during hemofiltration in canine endotoxic shock

Rogiers, Peter; Zhang, Haibo; Pauwels, Dirk; Vincent, Jean‐Louis

doi:10.1097/01.ccm.0000060446.45080.c6

Cited by 38 publications

(22 citation statements)

References 37 publications

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“…Among the three principles, filtration has been investigated most extensively in the last two decades in the form of a technique increasing filtration volumes (highvolume hemofiltration (HVHF)). Ronco et al conducted a randomized controlled trial (RCT) that compared therapeutic results of RRT in AKI at three different treatment doses (20,35, and 45 mL/kg/h) [15]. Results demonstrated that the survival rate was higher in the 35 and 45 mL/kg/h groups than in the 20 mL/kg/h group.…”

Section: Why Cytokine-adsorbing Hemofilter?mentioning

confidence: 99%

“…As the AN69 membrane has a hydrogel structure, adsorption to this membrane is considered to take place not only on the membrane surface but also within the bulk layer, thereby exhibiting a high adsorption capacity. In fact, native AN69 membrane is reported to adsorb a greater amount of humoral mediators such as cytokines compared with PS membrane [35].…”

Section: Pmma Hemofiltermentioning

confidence: 99%

“…However, cytokine levels, once reduced, subsequently increased again during CVVH and the AN69 hemofilter had to be replaced once every 3 h. Kellum et al demonstrated that AN69-CVVH in a murine sepsis model induced by cecal ligation and puncture suppressed an increase in blood IL-6 level [38]. When Rogiers et al performed CVVH using either a PS or an AN69 membrane hemofilter in dogs injected with endotoxin, significantly higher cardiac output, stroke volume, and left ventricular stroke work index were observed in the AN69 group [35].…”

Section: Pmma Hemofiltermentioning

confidence: 99%

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Cytokine-adsorbing hemofilter: old but new modality for septic acute kidney injury

Hattori

Oda

2016

Ren Replace Ther

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While evidence supporting the hypothesis that blood purification improve outcome in septic acute kidney injury (AKI) has not been established, many physicians hope to improve outcome in septic AKI by blood purification. Elucidation of the pathophysiology of sepsis has revealed close involvement of humoral mediators, including cytokines, pathogen-associated molecular patterns, and alarmins, in the development of severe sepsis. Removal of substances by blood purification involves three major principles, namely filtration, dialysis (diffusion), and adsorption. Multiple large randomized controlled trials (RCTs) of high-volume hemofiltration (HVHF) for patients with AKI were conducted, but failed to prove the clinical efficacy of HVHF. Blood purification for the removal of mediators through dialysis and filtration using a high cutoff (HCO) membrane hemofilter has not also been established. Furthermore, a HCO membrane hemofilter shares a common problem with HVHF, which is excessive removal of useful substances, such as antimicrobial agents and/or nutrients. Accordingly, continuous hemodiafiltration using cytokine-adsorbing hemofilters (CAH-CHDF) such as polymethylmethacrylate (PMMA) and AN69ST membrane hemofilters has been attracting attention recently. In this review, we report recent findings regarding these old hemofilters with new applications. Although the number of in vitro and in vivo studies conducted to date has been limited, the studies suggest a possibility that these modalities are useful particularly for the treatment of septic shock and septic AKI. CAH-CHDF is expected to be recognized globally as a treatment of septic shock and septic AKI in the near future.

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Section: Why Cytokine-adsorbing Hemofilter?mentioning

confidence: 99%

Section: Pmma Hemofiltermentioning

confidence: 99%

Section: Pmma Hemofiltermentioning

confidence: 99%

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Cytokine-adsorbing hemofilter: old but new modality for septic acute kidney injury

Hattori

Oda

2016

Ren Replace Ther

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“…AN69 and polysulfone are two of the most commonly used membranes in the ICU to provide CVVH and CVVHD in the last decades [27][28][29][30][31][32][33] . They present different physicochemical properties [31,34] and have been previously compared with diverse purposes [28,31,35] and different conclusions have been reached.…”

Section: Discussionmentioning

confidence: 99%

Elimination of Piperacillin and Tazobactam by Renal Replacement Therapies with AN69 and Polysulfone Hemofilters: Evaluation of the Sieving Coefficient

et al. 2006

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Background/Aim: Piperacillin-tazobactam is commonly used to treat infections in ICU patients. Controversial data have been published about the sieving/saturation coefficient (Sc/Sa) of piperacillin during continuous renal replacement therapies (CRRT). The objective was to evaluate the Sc/Sa of piperacillin-tazobactam during continuous venovenous hemofiltration (CVVH) and continuous venovenous hemodialysis (CVVHD) using AN69 and polysulfone. Methods: Ringer lactate, BSA-containing Ringer lactate and plasma were circulated at 150 ml/min. The ultrafiltrate/dialysis flow was kept at 1,500 ml/min. A bolus was injected and samples were taken. Drugs were measured using HPLC. Sc/Sa was calculated according to standard formula. Results: Free passage of drugs through the membranes was reported with protein free solutions. In the presence of proteins the Sc/Sa lowered and correlated to protein free fraction. Polysulfone had a significantly higher permeability than AN69 during CVVH. Conclusion: Drug binding to albumin contributes to the decrease of the Sc/Sa of piperacillin but it does not completely justify the in vivo value obtained by some authors.

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“…However, these effects that are supposed to be related to the adsorption properties of the membrane are temporary because of saturation phenomenon. 63 Some animal studies assessed HVHF by looking at ultrafiltrate obtained from either healthy donor or septic donor animals and infused into a healthy acceptor animal. The ability for HVHF to remove toxic mediators is suggested when ultrafiltrate obtained from septic animals leads to hemodynamic disturbances or even death in healthy animals.…”

mentioning

confidence: 99%

High-volume Hemofiltration in the Intensive Care Unit

Rimmelé

Kellum

2012

Anesthesiology

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Comparison of polyacrylonitrile (AN69) and polysulphone membrane during hemofiltration in canine endotoxic shock

Cited by 38 publications

References 37 publications

Cytokine-adsorbing hemofilter: old but new modality for septic acute kidney injury

Cytokine-adsorbing hemofilter: old but new modality for septic acute kidney injury

Elimination of Piperacillin and Tazobactam by Renal Replacement Therapies with AN69 and Polysulfone Hemofilters: Evaluation of the Sieving Coefficient

High-volume Hemofiltration in the Intensive Care Unit

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