Contributions to nephrology最新文献_第3页

Hemoperfusion in Leptospirosis. 钩端螺旋体病的血液灌注。

4区医学

Contributions to nephrology Pub Date : 2023-01-01 Epub Date: 2023-06-01 DOI: 10.1159/000527571

Romina A Danguilan

引用次数: 0

Rationale for Adsorption in Extracorporeal Blood Purification. 体外血液净化吸附原理。

4区医学

Contributions to nephrology Pub Date : 2023-01-01 Epub Date: 2023-06-01 DOI: 10.1159/000527707

Thiago Reis, Fábio Reis, Antônio Fagundes, Rogério da Hora Passos, Francisco de Assis Rocha Neves

{"title":"Rationale for Adsorption in Extracorporeal Blood Purification.","authors":"Thiago Reis, Fábio Reis, Antônio Fagundes, Rogério da Hora Passos, Francisco de Assis Rocha Neves","doi":"10.1159/000527707","DOIUrl":"10.1159/000527707","url":null,"abstract":"A strong rationale supports the development of adsorption-based extracorporeal blood purification in conditions such as sepsis, acute kidney disease, uremia, and acute liver failure. The retention of compounds as a consequence of acute or chronic organ dysfunction might have detrimental effects. When a causative effect of an accumulated compound in a pathogenic condition is demonstrated, a rationale for the removal of this solute is also established. Adsorption is a mass transfer mechanism in which a solute chemically interacts with the surface of a solid structure (sorbent) and is removed from its solvent (i.e., blood or plasma). Traditional extracorporeal blood purification techniques utilize semipermeable membranes and depend mainly on diffusion and convection as mechanisms of mass transfer. Protein-bound solutes and water-soluble compounds with molecular weight above 25 kDa are scantly removed by either diffusive or convective clearances. In contrast, recently developed resins have demonstrated safety aligned with notable adsorptive capability, which enables the extraction of endotoxins, inflammatory mediators, and uremic toxins. The understanding of the kinetics of these elements and the improvement in patient selection are key factors to propel exploratory and confirmatory trials that ultimately will lead to the expected changes in clinical practice.","PeriodicalId":10725,"journal":{"name":"Contributions to nephrology","volume":"200 ","pages":"107-117"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9947986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hemoperfusion in COVID-19. 新冠肺炎的血液灌注。

4区医学

Contributions to nephrology Pub Date : 2023-01-01 Epub Date: 2023-06-01 DOI: 10.1159/000527583

Tanat Lertussavavivat, Nattachai Srisawat

引用次数: 0

The Use of Adsorption in Extracorporeal Liver Support: The Double Plasma Molecular Adsorption System (DPMAS). 吸附在体外肝支持中的应用：双等离子体分子吸附系统（DPMAS）。

4区医学

Contributions to nephrology Pub Date : 2023-01-01 Epub Date: 2023-06-08 DOI: 10.1159/000529296

Guillermo J Rosa-Diez, Olivier Joannes-Boyau

{"title":"The Use of Adsorption in Extracorporeal Liver Support: The Double Plasma Molecular Adsorption System (DPMAS).","authors":"Guillermo J Rosa-Diez, Olivier Joannes-Boyau","doi":"10.1159/000529296","DOIUrl":"10.1159/000529296","url":null,"abstract":"Liver failure in the intensive care unit (ICU), whether acute or acute-on-chronic, remains a serious condition with reduced functions, various metabolite and toxin accumulation in the systemic circulation, and a high mortality rate. While transplantation remains the treatment of choice, the lack of organ transplants necessitates finding alternative solutions. Within the last years, several therapies aiming to support liver function have been developed in order to serve as a bridge to liver transplantation or as replacement therapy, allowing regeneration of the injured liver. In those therapies, nonbiological extracorporeal liver support devices are the most widely used, mainly based on detoxification by eliminating accumulated toxins notably by adsorption on specific membranes and/or with plasmapheresis. One of the most recent techniques is the double plasma molecular adsorption system combining plasma filtration and two specific adsorption membranes, which is largely described and studied in this chapter. This technique seems promising to remove deleterious toxins, cytokines and bilirubin in particular, is fairly simple to use, does not require a specific machine (it works on continuous renal replacement therapy machines), and has given encouraging results in the pilot studies published recently, in association with plasmapheresis or alone. However, further studies and evaluations are needed before this technique can be used routinely in ICU.","PeriodicalId":10725,"journal":{"name":"Contributions to nephrology","volume":"200 ","pages":"210-217"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9957555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hemoperfusion in Burns. 烧伤时的血液灌注。

4区医学

Contributions to nephrology Pub Date : 2023-01-01 Epub Date: 2023-06-08 DOI: 10.1159/000527709

Paul Abraham, Céline Monard, Antoine Lamblin, Antoine Schneider, Thomas Rimmelé

引用次数: 0

Hemoperfusion in Cardiac Surgery and ECMO. 心脏外科和ECMO中的血液灌注。

4区医学

Contributions to nephrology Pub Date : 2023-01-01 Epub Date: 2023-06-01 DOI: 10.1159/000527338

Paul Abraham, Vitor Mendes, Matthias Kirsch, Antoine Schneider

{"title":"Hemoperfusion in Cardiac Surgery and ECMO.","authors":"Paul Abraham, Vitor Mendes, Matthias Kirsch, Antoine Schneider","doi":"10.1159/000527338","DOIUrl":"10.1159/000527338","url":null,"abstract":"Extracorporeal circulation (ECC) such as cardiopulmonary bypass or extracorporeal membrane oxygenation (ECMO) may induce a complex activation of the immune system. To date, strategies to mitigate this activation have failed to translate into meaningful improvement of clinical outcomes. Hemoperfusion is a blood purification technique, which relies on mass separation by a solid agent (hemoadsorption). It can be performed by adding a cartridge filled with adsorptive sorbent in the extracorporeal circuit. These devices have the theoretical advantage to enable the removal of excess pro- and anti-inflammatory molecules. Several studies have demonstrated the feasibility and safety of hemoperfusion during cardiac surgery. They have suggested that the procedure could decrease cytokine levels in situations where they were elevated. However, further studies are required to determine the clinical indications, timing, and duration of hemoperfusion during cardiac surgery. Although a similar rationale can apply to hemoperfusion in ECMO, available data in this situation are even more limited and results are conflicting. In this chapter, we discuss the rationale for hemoperfusion with ECC, how to practically do it, and the current level of evidence supporting this therapy.","PeriodicalId":10725,"journal":{"name":"Contributions to nephrology","volume":"200 ","pages":"180-191"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9947984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bilirubin Adsorption with DPMAS: Mechanism of Action and Efficacy of Anion Exchange Resin. DPMAS对胆红素的吸附：阴离子交换树脂的作用机理和功效。

4区医学

Contributions to nephrology Pub Date : 2023-01-01 Epub Date: 2023-06-01 DOI: 10.1159/000526729

Matteo Marcello, Claudio Ronco

{"title":"Bilirubin Adsorption with DPMAS: Mechanism of Action and Efficacy of Anion Exchange Resin.","authors":"Matteo Marcello, Claudio Ronco","doi":"10.1159/000526729","DOIUrl":"10.1159/000526729","url":null,"abstract":"Acute liver failure and acute-on-chronic liver failure are conditions in which the loss of metabolic function of the liver leads to the accumulation of several toxins such as bilirubin. Patients with sepsis or multiple organ dysfunction syndrome have a greater risk of developing liver failure, and hyperbilirubinemia is associated with poor prognosis. Bilirubin removal may not only alleviate signs and symptoms of liver dysfunction but also act as an index of removal of albumin-bound toxins. Conjugated and unconjugated bilirubin, due to their molecular weight and albumin-binding capacity, respectively, cannot be removed by classic dialysis; therefore, different extracorporeal techniques have been developed to remove bilirubin from the blood. Plasma adsorption perfusion is an extracorporeal liver support technique in which bilirubin is removed from the plasma through a specific adsorbing cartridge. Double plasma molecular adsorption system adds a broad-spectrum adsorption column for the removal of inflammatory mediators and antibodies and other medium toxins. Their use in the treatment of hyperbilirubinemia has been established with several emerging data indicating their efficacy when compared to other extracorporeal techniques. However, bilirubin adsorption kinetics has not been sufficiently elucidated, and more studies are needed to improve the quality of treatment in terms of timing and prescriptions.","PeriodicalId":10725,"journal":{"name":"Contributions to nephrology","volume":"200 ","pages":"201-209"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9954265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preface. 序言

4区医学

Contributions to nephrology Pub Date : 2023-01-01 Epub Date: 2023-06-01 DOI: 10.1159/000530016

Rinaldo Bellomo, Claudio Ronco

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Chemical-Physical Mechanisms of Adsorption for Blood Purification. 血液净化吸附的化学物理机制。

4区医学

Contributions to nephrology Pub Date : 2023-01-01 Epub Date: 2023-05-22 DOI: 10.1159/000529402

Sabrina Copelli, Anna Lorenzin, Claudio Ronco

引用次数: 0

Introduction. 介绍。