blood purification
Recently Published Documents


TOTAL DOCUMENTS

687
(FIVE YEARS 206)

H-INDEX

30
(FIVE YEARS 8)

2021 ◽  
Vol 17 (4) ◽  
Author(s):  
Emanuela Biscardi ◽  
Giuseppe Carpinteri ◽  
Pietro Castellino ◽  
Lorenzo Malatino

Circulating inflammatory mediators and cytokines play a pivotal role in the progression of sepsis, leading in turn to septic shock, organ failure and resistance to standard therapy. Blood purification therapies may be adjuvant treatment for severe sepsis, but results have been shown to be so far controversial. Recently, CytoSorb has achieved promising outcomes on reduction of cytokine blood levels, improvement of clinical parameters and mortality in sepsis, as well as in other acute conditions. It is mostly used in Intensive Care Unit (ICU), in isolated hemoperfusion, or inserted in other circuits in addition to Continuous Renal Replacement Therapy (CRRT), heart-lung machines and extracorporeal membrane oxygenation. We report a case of septic shock occurred in our Emergency Department-High Dependency Unit (ED-HDU), resistant to standard therapy and improved after CytoSorb, so avoiding ICU hospitalization.


2021 ◽  
pp. 12-15
Author(s):  
Arjun Gupta ◽  
Rishu Sharma ◽  
Sonam Gupta

Ayurveda is old science which deals with many surgical and parasurgical procedures for the management of different pathological conditions. Amongst the many unique modalities Raktamokshan (bloodletting) is one of the important modality which provides health benefits in many diseases. Acharya Sushruta described importance of this procedure in conditions involving vitiation of Rakta and Dosha. Vitiation of Rakta is responsible for many health issues including skin problems and Raktamokshan helps greatly in this regard. Leech therapy, venesection and cupping therapy are subtype of Raktamokshan which helps in blood purification. The bloodletting therapies gaining attention of modern science due to their technical advancement. Raktamokshana mainly involves various techniques of blood liberation. Raktamokshan helps to treat conditions like eczema, swellings, inflammations and poisoning, etc.


2021 ◽  
pp. 1-7
Author(s):  
Simão C. Rodeia ◽  
Francisca Lopes Martins ◽  
Philip Fortuna ◽  
Luís Bento

Respiratory failure and systemic inflammation are paramount features of severe SARS-CoV-2 disease (COVID-19). Extracorporeal membrane oxygenation (ECMO) therapy has a potential role in patients with refractory disease. An inflammatory response due to blood contact with hemofilters, functioning as a synergic inflammatory stimulus, can lead to a hyperinflammatory state, relatable to cytokine release syndromes. After the first patient succumbed to a refractory vasodilatory shock believed to be due to hyperinflammatory state, a strategy of blood purification through cytokine adsorption therapy (CAT) with CytoSorb® was designed. In this case series, the authors describe the initial experience with such strategy. CAT was employed with no direct complications and helped controlling the inflammatory state, with all patients halting vasopressor support in 72 h and biomarker levels (C-reactive protein, ferritin, and interleukin-6) showing negative trends in most patients. Analysis of inflammatory biomarkers evolution highlighted 2 biomarker profiles related to the presence or absence of superinfection at the time of CAT implementation. In this case series of severe COVID-19 patients, 3 patients died – irreversible lung fibrosis, complications of critical hypoxemia before ECMO induction and complications of systemic anticoagulation were the causes. This case series aimed to contribute to the body of evidence substantiating CAT utilization in hyperinflammatory patients, namely, COVID-19 patients requiring ECMO rescue.


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Hiroyuki Yamada ◽  
Shigeru Ohtsuru

AbstractCoronavirus disease 2019 (COVID-19) threatened human lives worldwide since first reported. The current challenge for global intensivists is to establish an effective treatment for severe COVID-19. Blood purification has been applied to the treatment of various critical illnesses. Theoretically, its technique also has an enormous possibility of treating severe COVID-19 in managing inflammatory cytokines and coagulopathy. Recent clinical studies have revealed the positive clinical effect of therapeutic plasma exchange. Other studies have also indicated the considerable potential of other blood purification techniques, such as Cytosorb, AN69 surface-treated membrane, and polymyxin b hemoperfusion. Further research is needed to elucidate the actual effects of these applications.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
A. I. Burov ◽  
T. A. Abramov ◽  
N. S. Kostritca ◽  
D. S. Korotkov ◽  
G. V. Danilov ◽  
...  

Abstract Background For patients with primary brain injury, septic shock is especially dangerous due to the possibility of secondary cerebral damage. The key factor of sepsis-associated brain injury is inflammatory mediators, pathogen and damage-associated molecular patterns (PAMPs, DAMPs) release. Theoretically, blood purification may be beneficial for patients with primary brain injury due to its possibility for fast removal of inflammatory mediators. Case presentation We report on six post-neurosurgery septic shock patients treated with combined blood purification (CBP), which included CRRT with high adsorption capacity membrane in combination with CytoSorb adsorber. Clinical improvement in the course of CBP was registered in all patients. Three patients had a stable clinical improvement; the other three patients had only a transient improvement due to underlying neurological and cardiac deficits aggravation. We observed septic shock reversal in four patients. The key observations of the case series are a significant decrease in MOF severity (measured by SOFA score) and in catecholamine need (not statistically significant). By the end of CBP we observed a significant decrease in blood lactate, PCT and IL-6 levels. Two patients demonstrated level of consciousness increase in the setting of CBP therapy measured by GCS and FOUR score. Conclusion This case series demonstrates that CBP therapy may have a role for septic shock patients with primary brain injury.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Liping Liu ◽  
Yanyan Liu ◽  
Aimin Xing ◽  
Siyu Chen ◽  
Mingli Gu

This study was to explore the CT image features based on intelligent algorithm to evaluate continuous blood purification in the treatment of severe sepsis caused by pulmonary infection and nursing. 50 patients in the hospital were selected as the research objects. Convolutional neural network algorithm was used to segment CT images of severe sepsis caused by pulmonary infection. They were randomly divided into 25 cases of experimental group and 25 cases of control group. The experimental group was given continuous blood purification treatment, combined with comprehensive nursing. The control group was given routine treatment and basic nursing. Fasting plasma glucose (FPG) and fasting insulin (FIN), interleukin-6 (IL-6), tumor necrosis factor (TNF-α), high-sensitivity c-reactive protein (hs-CRP) levels, CD3+, CD4+, CD4+/CD8+ levels, ICU monitoring time, malnutrition inflammation score (MIS), and incidence of adverse events were compared between the two groups before and after treatment. There was no difference in FPG and FIN between the two groups before treatment. After treatment, the FPG and FIN of the experimental group were lower than those of the control group, and there was statistical significance ( P < 0.05 ). There was no difference in IL-6, TNF-α, and hs-CRP between the two groups before treatment. After treatment, IL-6, TNF-α, and hs-CRP in the experimental group were lower than those in the control group. There was no difference in the percentage of CD3+, CD4+, and CD4+/CD8+ between the two groups before treatment. After treatment, the CD3+, CD4+, and CD4+/CD8+ in the experimental group were higher than those in the control group. The ICU monitoring time, MIS, and incidence of adverse events in the experimental group were lower than those in the control group ( P > 0.05 ). Convolutional neural network algorithm can accurately identify and segment CT images of patients with severe sepsis, which has high clinical application value. Continuous blood purification therapy can effectively control blood glucose level, improve immune function, and reduce the content of inflammatory factors in patients with severe sepsis caused by pulmonary infection. Effective nursing measures can improve the therapeutic effect.


2021 ◽  
Vol 9 ◽  
Author(s):  
Hongjun Chen ◽  
Leisheng Zhang ◽  
Wei Zhang ◽  
Lili Liu ◽  
Zhihua Dai ◽  
...  

Objective: The ongoing coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to a worldwide pandemic. Currently, supportive care measures remain the standard of care for severe and critical COVID-19 patients, such as ventilation oxygenation, fluid management and blood purification. In this study, we aimed to evaluate the effects of early blood purification therapy upon severe and/or critical COVID-19 patients.Patients and Methods: From January 31, 2020 to March 1, 2020, a total 5 patients with COVID-19 (3 critical type cases and 2 severe type cases) received early blood purification treatment in the intensive care unit (ICU) of Affiliated Hospital of Zunyi Medical University. Clinical indexes, including oxygen concentration, blood gas analysis, oxygenation index, and laboratory test as well as disease scores were recorded and analyzed before and after the treatment with blood purification.Results: Among the 5 patients, 4 were males ranging from 35 to 80 year old (Mean age = 63 ± 17.87). All cases with characteristics of OI &lt;300 mm Hg, decline in lymphocyte (LYMPH)%, boost in lactate dehydrogenase (LDH), troponin T (TNT), B-type brain natriuretic peptide (BNP), interleukin-6 (IL-6) and interferon-alpha (IFN-a), three with high flow nasal cannula (HFNC), two with non-invasive ventilation (NIV) and acute kidney injury (AKI), and one with shock and IV. Blood purification therapy significantly decreased the serum levels of inflammatory cytokine, ameliorated the concomitant symptoms and complications. Finally, one case was discharged from the hospital, 4 cases were transferred to the general ward, and all the 5 cases survived.Conclusion: Continuous blood purification therapy held promising prospects for alleviating the deteriorative progression of severe and critical types of COVID-19 in the early stage, together with ameliorating the accumulation of inflammatory cytokine and the concomitant symptoms and complications by efficacious immunoadsorption.Trial Registration:www.chictr.org.cn, Identifier (ChiCTR2000031930).


Sign in / Sign up

Export Citation Format

Share Document