Treatment of severe sepsis and septic shock by CHDF using a PMMA membrane hemofilter as a cytokine modulator

Contrib Nephrol. 2010;166:73-82. doi: 10.1159/000314855. Epub 2010 May 7.

Abstract

It has been reported that various types of blood purification intended for the removal of humoral mediators, such as cytokines, were performed in patients with severe sepsis/septic shock. While high-volume hemofiltration, hemofiltration using high cut-off membrane filters, and direct hemoperfusion with a polymyxin-B immobilized column are widely used in the treatment of severe sepsis/septic shock, we perform continuous hemodiafiltration using a polymethylmethacrylate membrane hemofilter (PMMA-CHDF), which shows an excellent cytokine-adsorbing capacity, for the treatment of severe sepsis/septic shock. In our previous study, it was found that PMMA-CHDF could efficiently remove various pro-inflammatory cytokines such as TNFalpha, IL-6 and IL-8 from the bloodstream, resulting in early recovery from septic shock. Furthermore, PMMA-CHDF could remove anti-inflammatory cytokines such as IL-10 from bloodstream, suggesting that it might improve immunoparalysis as well. These findings suggest that PMMA-CHDF is useful for the treatment of patients with severe sepsis/septic shock as a cytokine modulator.

Publication types

  • Review

MeSH terms

  • Cytokines / blood
  • Cytokines / isolation & purification*
  • Hemodiafiltration / instrumentation
  • Hemodiafiltration / methods*
  • Humans
  • Interleukin-10 / blood
  • Interleukin-10 / isolation & purification
  • Interleukin-6 / blood
  • Interleukin-6 / isolation & purification
  • Interleukin-8 / blood
  • Interleukin-8 / isolation & purification
  • Membranes, Artificial
  • Polymethyl Methacrylate
  • Sepsis / therapy*
  • Shock, Septic / therapy*
  • Tumor Necrosis Factor-alpha / blood
  • Tumor Necrosis Factor-alpha / isolation & purification

Substances

  • Cytokines
  • Interleukin-6
  • Interleukin-8
  • Membranes, Artificial
  • Tumor Necrosis Factor-alpha
  • Interleukin-10
  • Polymethyl Methacrylate