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Extracorporeal blood purification strategies in sepsis and septic shock:An insight into recent advancements

World Journal of Critical Care Medicine 2023年第2期12卷 71-88页

作者： Yatin Mehta Rajib Paul Abdul Samad Ansari Tanmay Banerjee Serdar Gunaydin Amir Ahmad Nassiri Federico Pappalardo Vedran Premužić Prachee Sathe Vinod Singh Emilio Rey Vela Institute of Critical Care and Anesthesiology Medanta the MedicityGurugram 12201India Department of Internal Medicine Apollo HospitalsJubilee HillsHyderabad 500033India Department of Critical Care Nanavati Max Super Specialty HospitalMumbai 400065India Department of Internal Medicine&Critical Care Medica Institute of Critical Care MedicineMedica Superspecialty HospitalKolkata 700099India Department of Cardiovascular Surgery University of Health SciencesAnkara City Hospital CampusAnkara 06933Turkey Department of Nephrology Shahid Beheshti University of Medical SciencesTehran 19839-63113Iran Cardiothoracic and Vascular Anesthesia and Intensive Care AO SS Antonio e Biagio e Cesare ArrigoAlessandria 15121Italy Department of Nephrology Clinical Hospital ZagrebClinic for internal diseasesZagreb 10000Croatia Department of Critical Care Medicine D.Y.Patil Medical CollegeSant Tukaram NagarPimpri ColonyPimpri-ChinchwadPune 411018India Department of Critical Care Medicine Institute of critical care MedicineHospital Name-Sir Ganga Ram HospitalNew Delhi 110001India Cardiac Surgery Intensive Care Unit Samaritan University HospitalBogotá11Colombia

BACKGROUND Despite various therapies to treat sepsis,it is one of the leading causes of mortality in the intensive care unit patients *** about the pathophysiology of sepsis has sparked interest in extracorporeal therapies(ECT)which are intended to balance the dysregulation of the immune system by removing excessive levels of inflammatory *** To review recent data on the use of ECT in sepsis and to assess their effects on various inflammatory and clinical *** In this review,an extensive English literature search was conducted from the last two decades to identify the use of ECT in sepsis.A total of 68 articles from peer-reviewed and indexed journals were selected excluding publications with only *** Results showed that ECT techniques such as high-volume hemofiltration,coupled plasma adsorption/filtration,resin or polymer adsorbers,and CytoSorb®are emerging as adjunct therapies to improve hemodynamic stability in ***®has the most published data in regard to the use in the field of septic shock with reports on improved survival rates and lowered sequential organ failure assessment scores,lactate levels,total leucocyte count,platelet count,interleukin-IL-6,IL-10,and TNF *** Clinical acceptance of ECT in sepsis and septic shock is currently still limited due to a lack of large random clinical *** addition to patient-tailored therapies,future research developments with therapies targeting the cellular level of the immune response are expected.

关键词： CytoSorb® hemadsorbers Inflammatory mediators Extracorporeal therapies Sepsis

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