Extracorporeal Renal Replacement Therapies in the Treatment of Sepsis: Where Are We?

Forni, Lui G.; Ricci, Zaccaria; Ronco, Claudio

doi:10.1016/j.semnephrol.2015.01.006

Cited by 13 publications

(8 citation statements)

References 79 publications

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“…The use of renal replacement therapy or plasma exchange in sepsis has been recommended in some treatment guidelines. However, there is no evidence that these modalities improve outcomes in pediatric septic shock ( 24 ).…”

Section: Invasive Meningococcal Diseasementioning

confidence: 99%

Invasive Meningococcal Disease in the Vaccine Era

Nadel

Ninis

2018

Front. Pediatr.

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Infection with the meningococcus is one of the main causes of meningitis and septicaemia worldwide. Humans are the only natural reservoir for the meningococcus which is found primarily as a commensal inhabitant in the nasopharynx in ~10% of adults, and may be found in over 25% of individuals during adolescence. Prompt recognition of meningococcal infection and early aggressive treatment are essential in order to reduce mortality, which occurs in up to 10% of those with invasive meningococcal disease (IMD). This figure may be significantly higher in those with inadequate or delayed treatment. Early administration of effective parenteral antimicrobial therapy and prompt recognition and appropriate management of the complications of IMD, including circulatory shock and raised intracranial pressure (ICP), are critical to help improve patient outcome. This review summarizes clinical features of IMD and current treatment recommendations. We will discuss the evidence for immunization and effects of vaccine strategies, particularly following implementation of effective vaccines against Group B meningococcus.

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Section: Invasive Meningococcal Diseasementioning

confidence: 99%

Invasive Meningococcal Disease in the Vaccine Era

Nadel

Ninis

2018

Front. Pediatr.

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“…Stężenie cytokin w surowicy gwałtownie wzrasta w przebiegu sepsy, co wiąże się z niekorzystnym rokowaniem [1]. W związku z tym postawiono hipotezę terapeutyczną o pozaustrojowej eliminacji znajdujących się we krwi PAMPs, DAMPs oraz mediatorów procesu septycznego w leczeniu sepsy [2].…”

Section: Wstępunclassified

Extracorporeal blood purification in sepsis

Kübler¹,

Wrocławiu²

2019

Medicine

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STRESZCZENIE:Pozaustrojowe oczyszczanie krwi jest uznaną metodą leczenia niewydolności nerek i zatruć. Na podstawie wyników takiego postępowania postawiono hipotezę o leczeniu sepsy przez usuwanie mediatorów procesu septycznego, uwalnianych podczas reakcji immunologicznej na zakażenie. Przeprowadzono badania nad różnymi technikami pozaustrojowymi: hemofiltracją o dużej objętości, hemofiltracją z filtrami o wysokim punkcie odcięcia, hemoadsorpcją lub kombinacjami tych metod. Opisano wiele pozytywnych wyników badań, ale o niewielkiej wartości dowodowej. Wieloośrodkowe, prospektywne, randomizowane badania kliniczne nie wykazały istotnego obniżenia śmiertelności w wyniku zastosowania tych metod. Obecnie nie ma wystarczających dowodów, aby zalecać stosowanie pozaustrojowego oczyszczania krwi w przyczynowym leczeniu sepsy.SŁOWA KLUCZOWE: sepsa, pozaustrojowe oczyszczanie krwi, hemofiltracja, hemoadsorpcja, endotoksyna ABSTRACT:Extracorporeal blood purification is an acclaimed method of treatment in renal insufficiency or intoxications. Based on the clinical outcomes of this therapeutic management, a hypothesis has been formed that sepsis could be treated by removing inflammatory mediators which are released during immunological response to infection. Studies of various extracorporeal blood purification techniques were conducted, including: high-volume haemofiltration, high cut-off haemofiltration, haemoadsorption or combinations of these methods. Although multiple positive results were described, they usually presented insignificant evidential value. Multicenter, prospective randomized clinical trials did not show any significant decrease in mortality due to instituting these therapeutic methods. Currently there is insufficient evidence to recommend extracorporeal blood purification for causal treatment in sepsis.

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“…Both HD and PD modalities have been used to treat patients with AKI [36][37][38][39]. However, AKI patients with sepsis, multiorgan failure and on ventilators in ICU have benefited from modern specific HD machines that permit safe and reliable therapy, easy performance and monitoring and are capable of performing continuous renal replacement therapy (CRRT) with multiple modalities [40][41][42]. These well-developed techniques include sequential ultrafiltration, continuous venovenous HD, continuous venovenous HF and continuous venovenous HDF [43].…”

Section: Aspects In Dialysismentioning

confidence: 99%

Introductory Chapter

Karkar¹

2018

Aspects in Dialysis

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Extracorporeal Renal Replacement Therapies in the Treatment of Sepsis: Where Are We?

Cited by 13 publications

References 79 publications

Invasive Meningococcal Disease in the Vaccine Era

Invasive Meningococcal Disease in the Vaccine Era

Extracorporeal blood purification in sepsis

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