Extracorporeal blood therapy in sepsis and acute respiratory distress syndrome： the ＂purifying dream＂  

作　　者：Xu Xuefeng Dai Huaping Jia Chun'e Wang Chen 

机构地区：[1]National Clinical Research Centre for Respiratory Medicine, Beijing Hospital, Beijing 100730, China [2]Department of Respiratory and Critical Care Medicine, B eijing Chao- Yang Hospital, Capital Medical University, Beijing 100020, China [3]Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing 100020, China

出　　处：《Chinese Medical Journal》2014年第24期4263-4270,共8页中华医学杂志（英文版）

基　　金：This work was supported by grants from National Natural Science Foundation of China （No. 81490530, 81490534, 81270123）, Beijing Natural Science Foundation （No. 7131008）, National Key Technology Research and Developement Program （No. 2012BAI05B02） and Special Scientific Research Fund of Public Welfare Profession of Ministry of Health （No. 201302017）.

摘　　要：Objective To discuss the rationale, hypothesis, modality of extracorporeal blood purification （EBP） techniques for the critically ill animal models or patients, and to summarize the experimental and clinical studies with inconsistent data which explored the EBP＇s efficacy in the areas of critical care medicine. Data sources Articles referred in this review were collected from the database of PubMed published in English up to June 2014. Study selection We had done a literature search by using the term ＂（sepsis OR acute lung injury OR acute respiratory distress syndrome） AND （extracorporeal blood purification OR hemofiltretion OR hemoperfusion OR plasma exchange OR plasmapheresis OR adsorpiton）＂. Related original or review articles were included and carefully analyzed. Results Acute cellular and humoral immune disturbances occur in both sepsis and acute respiratory distress syndrome （ARDS）. Treatments aimed at targeting one single pro-/anti-inflammatory mediator have largely failed with no proven clinical benefits. Such failure shifts the therapeutic rationale to the nonspecific, broad-spectrum methods for modulating the over-activated inflammatory and anti-inflammatory response. Therefore, EBP techniques have become the potential weapons with high promise for removing the circulating pro-/anti-inflammatory mediators and promoting immune reconstitution. Over the years, multiple extracorporeal techniques for the critically ill animal models or patients have been developed, including hemoflltration （HF）, high-volume hemofiltration （HVHF）, high-cutoff hemofiltration （HCO-HF）, hemo-perfusion or -adsorption （HP/HA）, coupled plasma filtration adsorption （CPFA）, and plasma exchange （PE）. These previous studies showed that EBP therapy was feasible and safe for the critically ill animal models or patients. However, data on their efficacy （especially on the clinical benefits, such as mortality） were inconsistent. Conclusions It is not now to conclude that EBP intervention canObjective To discuss the rationale, hypothesis, modality of extracorporeal blood purification （EBP） techniques for the critically ill animal models or patients, and to summarize the experimental and clinical studies with inconsistent data which explored the EBP＇s efficacy in the areas of critical care medicine. Data sources Articles referred in this review were collected from the database of PubMed published in English up to June 2014. Study selection We had done a literature search by using the term ＂（sepsis OR acute lung injury OR acute respiratory distress syndrome） AND （extracorporeal blood purification OR hemofiltretion OR hemoperfusion OR plasma exchange OR plasmapheresis OR adsorpiton）＂. Related original or review articles were included and carefully analyzed. Results Acute cellular and humoral immune disturbances occur in both sepsis and acute respiratory distress syndrome （ARDS）. Treatments aimed at targeting one single pro-/anti-inflammatory mediator have largely failed with no proven clinical benefits. Such failure shifts the therapeutic rationale to the nonspecific, broad-spectrum methods for modulating the over-activated inflammatory and anti-inflammatory response. Therefore, EBP techniques have become the potential weapons with high promise for removing the circulating pro-/anti-inflammatory mediators and promoting immune reconstitution. Over the years, multiple extracorporeal techniques for the critically ill animal models or patients have been developed, including hemoflltration （HF）, high-volume hemofiltration （HVHF）, high-cutoff hemofiltration （HCO-HF）, hemo-perfusion or -adsorption （HP/HA）, coupled plasma filtration adsorption （CPFA）, and plasma exchange （PE）. These previous studies showed that EBP therapy was feasible and safe for the critically ill animal models or patients. However, data on their efficacy （especially on the clinical benefits, such as mortality） were inconsistent. Conclusions It is not now to conclude that EBP intervention can

关 键 词：acute lung injury acute respiratory distress syndrome extracorporeal blood purification SEPSIS 

分 类 号：S947.12[农业科学—水产养殖] TQ226.36[农业科学—水产科学]