Blood Purification最新文献

{"title":"Effects of Daprodustat on Iron Metabolism in Peritoneal Dialysis Patients: An Exploratory Study.","authors":"Tomohiro Yan, Yukinao Sakai, Shunnosuke Kunoki, Akio Hirama, Tetsuya Kashiwagi, Masato Iwabu","doi":"10.1159/000548832","DOIUrl":"https://doi.org/10.1159/000548832","url":null,"abstract":"<p><p>Introduction Renal anemia is a serious complication in patients with chronic kidney disease. Daprodustat, a hypoxia-inducible factor-prolyl hydroxylase inhibitor, represents a potential therapeutic option for renal anemia; however, its efficacy and safety in patients maintained on peritoneal dialysis remains unknown. This exploratory study aimed to evaluate the preliminary effects of daprodustat in patients with chronic kidney disease undergoing maintenance peritoneal dialysis. Methods This single-center, prospective study included 11 patients undergoing maintenance peritoneal dialysis who shifted from darbepoetin alfa to daprodustat. Over a 24-week observation period, hematological parameters, iron metabolism markers, cardiac function, and oxidative stress indicators were monitored. Statistical significance was determined using repeated measures ANOVA with Bonferroni correction for multiple comparisons. Results Hepcidin-25 levels (p = 0.0004) and oxidized low-density lipoprotein levels (p = 0.0437) significantly decreased, while total iron-binding capacity (p = 0.0043) and reticulocyte counts (p = 0.0052) significantly increased. Despite these favorable biochemical changes, hemoglobin and hematocrit values showed no significant improvement. Other oxidative stress markers showed downward trends, while cardiac function parameters (N-terminal pro-brain natriuretic peptide, cardiothoracic ratio, left ventricular ejection fraction) remained unchanged. Conclusion This pilot study suggests that daprodustat may enhance iron metabolism and mitigate oxidative stress while preserving cardiac function in peritoneal dialysis patients. The pronounced reduction in hepcidin-25 levels indicates potential beneficial effects on iron homeostasis. However, the absence of significant hemoglobin improvement, combined with the small sample size (n=11), lack of control group, and short 24-week follow-up period, significantly limits the clinical relevance and generalizability of these findings. Larger randomized controlled trials with longer follow-up periods are essential to definitively establish the efficacy and safety of daprodustat in this patient population.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-19"},"PeriodicalIF":1.8,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Ultrafiltration Rate Influence Sleep Quality Among Hemodialysis Patients.","authors":"Cihan Uysal, Murat Altunok, Hamiyet Ozkan, Ismail Kocyigit","doi":"10.1159/000548767","DOIUrl":"https://doi.org/10.1159/000548767","url":null,"abstract":"<p><strong>Introduction: </strong>Sleep disturbances are common in hemodialysis (HD) patients. We examined the excessive ultrafiltration rate (UFR), which is associated with poor outcomes, for its possible impact on sleep quality.</p><p><strong>Methods: </strong>Only oligo-anuric patients with a three-times-weekly HD schedule were included in the study. Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality and a score> 5 indicated poor sleepers. Ultrafiltration values refer to the month preceding the PSQI survey. Patients were divided into three categories: optimal UFR group (<10 mL/kg/h), borderline UFR group (10-13 mL/kg/h), and high UFR group (≥13 mL/kg/h).</p><p><strong>Results: </strong>A total of 102 patients were included, with a median age of 60(46-67) years. Median time of undergoing dialysis was 44.5(22-77) months. Average interdialytic weight gain (IDWG) percentage was 4.7(3.7-5.7) and UFR was 11.6±3.5 mL/kg/h. 37 patients (36.3%) had optimal UFR, 29 patients (28.4%) had borderline UFR, 36 patients (35,3%) had high UFR. Average PSQI score was 7 points (4-10) and 61 patients (59.8%) was identified as poor sleepers. Mean UFR was 11.7±3.4 mL/kg/h in poor sleepers and 11.5±3.7 mL/kg/h in non-poor sleepers (p=0. 819). PSQI score and poor sleeper prevalence were not significantly different between UFR groups. There was no significant correlation between PSQI and UFR (p=0.325). In multivariate regression analysis, UFR was not an independent predictor of sleep quality. Additionally, younger age and a long history of HD were independent predictors of high UFR.</p><p><strong>Conclusion: </strong>Excessive and rapid fluid removal does not constitute a risk for poor sleep quality. Also, current findings underscore the increased frequency and complexity of sleep disorders in dialysis patients.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-17"},"PeriodicalIF":1.8,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional Citrate Anticoagulation in Pediatric Patients: Dealing With Practice Points.","authors":"Zaccaria Ricci, Akash Deep, Stuart L Goldstein","doi":"10.1159/000548786","DOIUrl":"https://doi.org/10.1159/000548786","url":null,"abstract":"<p><strong>Background: </strong>Regional citrate anticoagulation (RCA) for continuous renal replacement therapy (CRRT) has been shown to be safe and effective both in adult and children. The equipment and the solutions available in the pediatric setting are the same as in adults.</p><p><strong>Summary: </strong>Currently three commercially available citrate formulations for RCA during continuous renal replacement therapy CRRT are present: concentrated (4% trisodium citrate, 136 mmol/L), semi-concentrated (anticoagulant dextrose-A, ACD-A, 75 mmol/L) and diluted (Prismocitrate/Regiocit, 18 mmol/L). RCA is delivered as a predilution infusion solution, therefore its volume in dedicated commercially available citrate solutions impacts continuous renal replacement (CRRT) dose, filtration fraction, circuit pressures and fluids flow. These aspects represent crucial details in the pediatric setting, and its relevance is more important as smaller is the patient body weight. Thus, when RCA is prescribed in children, the blood pump flow rate, the dose, the load and the concentration of citrate, and the patient's ability to metabolize citrate should be considered carefully and specifically contextualized on the citrate concentration available in each center.</p><p><strong>Conclusion: </strong>This technical review will describe these practice concepts that should be known in detail by the clinician approaching RCA in the pediatric setting.</p><p><strong>Key messages: </strong>Citrate \"dose\" is the citrate concentration in the blood running in the CRRT circuit. Citrate \"load\" represents the mass of citrate that is delivered to the circuit per each treatment hour. For a given citrate dose and blood flow rate, very different CRRT settings, sodium loads, filtration fractions, and dialytic doses are delivered by choosing the different formulations.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-7"},"PeriodicalIF":1.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phoxilium® as a Phosphate-Sparing Solution for Continuous Renal Replacement Therapy in Paracetamol-Induced Acute Liver Failure.","authors":"Gabriel Chan, Caleb Fisher, Ian C Baldwin, Stephen Joseph Warrillow, Anis Chaba, Rinaldo Bellomo, Ary Serpa Neto","doi":"10.1159/000548502","DOIUrl":"https://doi.org/10.1159/000548502","url":null,"abstract":"<p><strong>Background: </strong>Hypophosphatemia is common in Acute Liver Failure (ALF) and may worsen during continuous renal replacement therapy (CRRT) with phosphate-free fluids. We aimed to evaluate the safety and efficacy of Phoxilium®, a phosphate-containing CRRT fluid.</p><p><strong>Methods: </strong>We conducted a retrospective single-centre cohort study of paracetamol-induced ALF patients treated with CRRT between as our ICU transitioned from Accusol® to Phoxilium®. We obtained data on demographics, biochemistry, and outcomes. We compared biochemical variables every 6 hours up to 48 hours post-CRRT initiation and then every 12 hours until 168 hours. The primary outcome was the occurrence of severe hypophosphatemia (< 0.32 mmol/L).</p><p><strong>Results: </strong>In 38 ALF patients (Phoxilium®=14 and Accusol®=24). Phoxilium® was associated with elimination of severe hypophosphatemia (0% vs. 38%; p=0.014), a reduction in its median burden (proportion of phosphate readings < 0.81 mmol/L: 13% [IQR; 2-33%] vs. 44% [29-51%]; p=0.001), and significantly lower phosphate supplementation requirements (median, 45 mmol [20-70 mmol] vs. 100 mmol [60-210 mmol]; p=0.008). Phoxilium® patients experienced a small but significant decrease in median arterial pH and standard base excess, which remained within normal limits, but lower than with Accusol® (p = 0.018 and p = 0.046, respectively). No significant differences were observed in clinical outcomes.</p><p><strong>Conclusions: </strong>In paracetamol-induced ALF patients, Phoxilium® was associated with reduced incidence of severe hypophosphatemia, hypophosphatemia burden, and need of phosphate supplementation. Larger studies are needed to further assess its impact on ALF patient outcomes.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-21"},"PeriodicalIF":1.8,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemolysis Monitoring Practices during ECMO: A Survey Report.","authors":"Amy E Strong, Kristina Rudolph, Michelle R Denburg, Aditya Badheka","doi":"10.1159/000548469","DOIUrl":"https://doi.org/10.1159/000548469","url":null,"abstract":"<p><p>Introduction Intravascular hemolysis is a significant complication of extracorporeal membrane oxygenation (ECMO), associated with adverse outcomes such as kidney failure and increased mortality. There is wide variability in the cited incidence of this complication. This survey study aimed to characterize the variability in hemolysis monitoring practices across ECMO centers. Methods The survey, distributed via the Extracorporeal Life Support Organization (ELSO) newsletter, received 26 responses from various healthcare professionals, including nurses, perfusionists, respiratory therapists, and physicians. Respondents represented both pediatric and adult ECMO units, primarily from academic centers in the United States (46%). Results Findings revealed that 92% of these centers use centrifugal pumps, with Heparin and Bivalirudin being the preferred anticoagulants. While 68% of respondents reported having a standard protocol for hemolysis monitoring, the specific protocols varied widely. Plasma free hemoglobin was the most commonly monitored laboratory test. Definitions for what was considered significant hemolysis varied as well and was primarily identified by red urine and elevated plasma hemoglobin levels. Interventions to address hemolysis included adjusting pump speed, repositioning cannulas, replacing pump heads or oxygenators, and performing plasmapheresis. Conclusions The study highlights the variability in hemolysis monitoring practices among ECMO centers. Further research is warranted to establish optimal monitoring protocols to detect and potentially treat the complication of hemolysis.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-7"},"PeriodicalIF":1.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of far infrared treatment on changes in biomarkers in the arteriovenous fistula.","authors":"Emilie K Hansen, Ditte Hansen, Casper Schalkwijk, Marjo Waarenburg, Henrik Post Hansen, Kristine Lindhard","doi":"10.1159/000547478","DOIUrl":"https://doi.org/10.1159/000547478","url":null,"abstract":"<p><p>Introduction Far infrared radiation may improve arteriovenous fistula maturation and patency rates in patients on hemodialysis (HD). The mechanism is proposed to involve anti-inflammatory and vasodilatory effects in the arteriovenous fistula. This study examined the impact of far infrared radiation on plasma changes and dialysate excretion of biomarkers of endothelial dysfunction, inflammation, and vasodilation in the arteriovenous fistula during a single HD. Methods The study was a randomized controlled single-blinded study in 44 participants on HD with an arteriovenous fistula. Participants were randomized to far infrared radiation or no far infrared radiation (control). Blood samples and dialysate water were drawn before, during and after four hours of HD. The change and elimination of biomarkers of endothelial dysfunction, inflammation and vasodilation was explored in blood and dialysate water, respectively. Changes in plasma levels from start to end of HD and the area under the curve for the biomarker concentration were compared between groups by ANCOVA. Results There was no difference in the change of biomarkers of endothelial dysfunction, inflammation, and vasodilation between the two groups after and during four-hours of HD. There was a minimal excretion of the biomarkers in the dialysate water. Regardless of treatment group, four-hours of HD caused a significant decrease in tumor necrosis factor-alpha (-1.30 [-1.70;-1.03] pg/ml , P= <0.001), monocyte chemoattractant protein-1 (-32.50 [-50.50;-8.25] pg/ml, P= <0.001), nitrite, and nitrate (-20.00 [-27.75;-14.00] µmol/L, P= <0.001) as well as asymmetric dimethylarginine(-0.24 [-0.28;-0.18], µmol/L P= <0.001). Conclusion Overall, the study is not supportive of a beneficial effect of far infrared radiation on the arteriovenous fistula on biomarkers of endothelial dysfunction, inflammation or vasodilation during one HD treatment.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-12"},"PeriodicalIF":1.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sotagliflozin reduces glucose absorption and improves ultrafiltration in a rat model of chronic peritoneal exposure to high-glucose dialysate.","authors":"Yuanyuan Shi, Zi Jiang, Lijie Zhang, Zhanzheng Zhao, Jing Xiao","doi":"10.1159/000547528","DOIUrl":"https://doi.org/10.1159/000547528","url":null,"abstract":"<p><strong>Introduction: </strong>Unwanted glucose exposure and absorption during peritoneal dialysis (PD) remain clinical challenges. Recent studies have attempted to reduce glucose absorption in PD via use of selective sodium glucose cotransporter 2 (SGLT2) inhibitors, but results have been inconsistent and even paradoxical. We aimed to (i) explore whether both SGLT1 and SGLT2 are expressed and their respective anatomical localizations and proportions in the peritoneum and (ii) elucidate whether dual SGLT1/SGLT2 inhibition could reduce glucose absorption and improve ultrafiltration using a uremia chronic PD rat model.</p><p><strong>Methods: </strong>24 male Sprague‒Dawley rats were randomly divided into four groups (each n=6): the sham operation group, uremia group, uremia PD group and sotagliflozin-treated group (a dual SGLT1+2 inhibitor). The expression levels of both SGLT1 and SGLT2 were determined by immunohistochemistry and western blot analysis. Peritoneal transport function was monitored via a peritoneal equilibration test (PET).</p><p><strong>Results: </strong>Both SGLT1 and SGLT2 are comparably expressed in the rat peritoneum and are prominently located in the vascular endothelium and peritoneal mesothelium. Compared with sham controls, uremia rats presented significantly increased expressions of both SGLT1 and SGLT2, and their expressions were further significantly increased after high glucose PDF exposure for 5 weeks but markedly reversed by sotagliflozin cotreatment. Compared with the sham controls, uremia rats were characterized by greater glucose absorption, increased blood glucose levels, a lower D/D0 glucose ratio, a higher D/P cr ratio, a higher D/P urea ratio, and less net ultrafiltration. After infusion of high glucose PDF for 5 weeks, these changes were more marked and were substantially ameliorated by sotagliflozin cotreatment.</p><p><strong>Conclusions: </strong>High glucose PDF significantly increased the peritoneal expressions of both SGLT1 and SGLT2, which in turn facilitated more glucose absorption, eventually leading to a vicious cycle. Sotagliflozin may emerge as a novel strategy in PD to reduce glucose diffusion and enhance ultrafiltration.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-23"},"PeriodicalIF":1.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal Blood Purification with the oXiris® Filter for Patients with Sepsis and Hyperinflammatory Conditions: The Asia-Pacific oXiris Expert Meeting 2024 Consensus Statements.","authors":"Ling Zhang, Nattachai Srisawat, Cheng-Chia Lee, Dong Hyun Lee, Kyungho Lee, Zhanguo Liu, Fariz Safhan Mohamad Nor, Ruslinda Bt Mustafar, Sadudee Peerapornratana, Huy Minh Pham, Sewa Duu Wen Sewa, Gloria Kai Yan Tang, Yu-Chang Yeh, Mingli Zhu, Qiang Yao, Minmin Wang, Rinaldo Bellomo","doi":"10.1159/000548214","DOIUrl":"https://doi.org/10.1159/000548214","url":null,"abstract":"<p><p>Extracorporeal blood purification (EBP) is an emerging technique for reducing elevated levels of inflammatory mediators and/or endotoxins in critically ill patients with sepsis or other hyperinflammatory conditions. The oXiris filter combines endotoxin adsorption, cytokine adsorption, hemofiltration and anti-thrombosis, and an emerging body of evidence demonstrates its use in critical care patients with hyperinflammatory conditions and acute kidney injury (AKI). A group of Asia-Pacific experts convened to formulate consensus statements for the use of the oXiris filter based on a comprehensive review of publications. After evaluation using a Delphi methodology, 17 statements achieved consensus (three recommendations and 14 practice points). These offer guidance on the initiation, monitoring and evaluation of treatment with the oXiris filter in patients with sepsis, septic shock, severe COVID-19 or other hyperinflammatory states. We also recommend using the oXiris filter in patients undergoing cardiopulmonary bypass for cardiac surgery who are at risk for developing AKI. Other statements discuss modality, dosage, filter lifespan, anticoagulation and combining the oXiris filter set with other extracorporeal therapies. Taken together, our statements offer targeted guidance for clinicians on the use of the oXiris filter across different patient populations. Additionally, we highlight the limitations of the current evidence base and identify key areas requiring further research.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-28"},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current status of continuous renal replacement therapy in Japanese intensive care units: a multicenter retrospective observational study.","authors":"Hidehiko Nakano, Ryota Inokuchi, Yutaro Inoue, Motohiro Sekino, Yasuyuki Kakihana, Noriyuki Hattori, Mariko Miyazaki, Natsuko Tokuhira, Shigeki Fujitani, Yuichiro Toda, Yoshifumi Ohchi, Hiroshi Morimatsu, Shingo Ichiba, Yoshiki Masuda, Osamu Nishida, Takaya Abe, Takeshi Moriguchi, Kasumi Satoh, Masafumi Idei, Hiromasa Nagata, Kent Doi","doi":"10.1159/000548371","DOIUrl":"https://doi.org/10.1159/000548371","url":null,"abstract":"<p><strong>Introduction: </strong>Continuous renal replacement therapy (CRRT) is often performed for critically ill patients in intensive care units (ICUs), but its optimal indication and settings have yet to be determined. Thus, we aimed to describe the current status of CRRT in Japan through a multicenter retrospective observational study.</p><p><strong>Methods: </strong>Adult ICU patients receiving CRRT at 18 tertiary hospitals in Japan (up to 100 patients from each hospital over the past year) were retrospectively enrolled. Patients receiving CRRT for <24 hours or intermittent renal replacement therapy together with CRRT were excluded. The primary outcomes were the temporal changes in the electrolyte levels, acid-base balance, and uremia-related small solute concentrations. The secondary outcomes included potassium (K) and phosphate (P) supplementations during CRRT.</p><p><strong>Results: </strong>Altogether, 1045 patients were enrolled. The median CRRT duration and dose were 4.4 days and 17.3 mL/kg/hr, respectively. The electrolyte levels, acid-base balance, and uremia-related small solute concentrations returned to normal by day 4 of treatment. A total of 732 (70.0 %) patients received K supplementation, and only a few patients had hypokalemia until day 5. Moreover, 414 (39.6%) patients received P supplementation, and approximately 30%-50% of the patients had hypophosphatemia until day 5.</p><p><strong>Conclusion: </strong>The electrolyte level abnormalities and acid-base imbalances of the studied patients were improved within 72-96 hours of CRRT. Contrarily, K and P supplementations were common, indicating that the current CRRT solutions need to be modified.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-19"},"PeriodicalIF":1.8,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145028824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Removal of psychotropic drugs by hemoadsorption with the HA380 cartridge.","authors":"Taku Furukawa, Yugeesh R Lankadeva, Ian C Baldwin, Pei Chen Connie Ow, Sally Hood, Chin Bin Eap, Antoine Schneider, Laurent A Decosterd, Rinaldo Bellomo","doi":"10.1159/000547371","DOIUrl":"https://doi.org/10.1159/000547371","url":null,"abstract":"<p><strong>Introduction: </strong>Psychotropic drug intoxication may require urgent management. Hemoadsorption (HA) may detoxify blood in such cases, but its effect has not been quantified.</p><p><strong>Methods: </strong>We studied in-vivo removal of valproate, quetiapine and escitalopram with HA using the Jafron HA 380 cartridge in six sheep. We measured the removal rate (RR) and clearance (CL) of each agent over time.</p><p><strong>Results: </strong>Mean sorbent-based valproate RR was initially 55.8% (CL 58.2 mL/min), but declined to negligible at 120 min. Mean initial RR for quetiapine was > 90% and remained high (72%) at 4-hours with CL of 87.2 mL/min at 10 minutes and 68.7 mL/min at 240 min. Mean RR of escitalopram exceeded 90 % at 10 minutes and decreased to 66.9 % at 4 hours. The mean CL was 88.0 ml/min at 10 min and 63.2 ml/min at 240 min.</p><p><strong>Conclusion: </strong>HA with the HA380 cartridge achieves effective removal of valproate, quetiapine and escitalopram. For valproate, adsorptive performance progressively declined over the 4-hour treatment period. In contrast, with quetiapine and escitalopram, the function remained substantial for up to 4 hours. Further research is required to optimize HA strategies for these drugs and facilitate clinical translation of HA-based blood detoxification.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-17"},"PeriodicalIF":1.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}