Abstract
The concept of hemodialysis and peritoneal dialysis for renal failure, which has been so successful, has been expanded into a number of techniques caled blood purification. Plasmapheresis has a role in die management of refractory myasthenia gravis, Goodpasture syndrome, hemolytic uremia, and Guillain-Barré syndrome.1 There is no doubt that removal of toxic products from the blood, such as endotoxin and mediator cytokines, could help sick, injured and septic patients. A number of clinical trials have suggested benefit for patients with systemic inflammatory response syndrome (SIRS), multiple organ dysfunction syndrome (MODS), and multiple organ failure (MOF). There are a number of clinical problems that could be helped by such techniques in addition to the removal of potassium, urea nitrogen, and creatinine for renal failure (see Chapter 36). Potential benefits include (1) removal of excess fluid contributing to heart failure, pulmonary edema, and impaired arterial and tissue oxygenation; (2) removal of humoral mediators of inflammation; (3) removal of endotoxin; (4) nutritional management; (5) correction of fluid, electrolyte, and acid-base balance; (6) support as an artificial liver (see Chapter 44).
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Ronco C, Brendolan Aj Bllomo R: Current technology for continuous renal replacement therapies. In: Ronco C, Bellomo R (eds) Critical Care Nephrology. Dordrecht, Kluwer Academic, 1998; 1269–1308.
Hirasawa H, Sugai T, Ohtake Y, et al: Blood purification for prevention and treatment of multiple organ failure. World J Surg 1998; 20: 482–486.
Baue AE, Hirasawa H: Editorial overview of the surgical patient. Curr Opin Crit Care 1997; 3: 279–285.
Hanasawa K, Kodama M, Aoki H, et al: New treatment of severe sepsis in septic multiple organ failure patients by extracorporeal endotoxin removal with a polmyxin B immobilized fiber column. Surg Forum 1993; 44: 88–89.
Aoki H, Kodama M, Tani T, Hanasawa K: Treatment of sepsis by extracorporeal elimination of endotoxin using polymyxin B-immobilized fiber. Am J Surg 1994; 167: 412–417.
Kodama M, Tani T, Maekawa K, et al: Endotoxin eliminating therapy in patients with severe sepsis-direct hemoperfusion using polymyxin B-immobilized fiber column. Jpn J Surg 1995; 96: 277–285.
Hirasawa H, Sugai T, Ohtake Y, et al: Continuous hemofiltration and hemodiafiltration in the management of multiple organ failure. Contrib Nephrol 1991; 93: 42–51.
Hirasawa H, Sugai T, Oda S, et al: Continuous hemodiafiltration (CHDF) removes cytokines and improves respiratory index (RI) and oxygen metabolism in patients with acute respiratory distress syndrome (ARDS). Crit Care Med 1998; 26: 294.
Bellomo R, Tipping P, Boyce N: Continuous veno-venous hemofiltration with dialysis remove cytokines from the circulation of septic patients. Crit Care Med 1993; 21: 522–529.
Schetz M, Ferdinande P, van den Berghe G, et al: Removal of proinflammatory cytokines with renal replacement therapy: sense or nonsense? Intensive Care Med 1995; 21: 169–175.
Hrasawa H, Sugai T, Oda S, et al: Continuous hemodiafiltration can remove humoral mediators from bloodstream of the patients with systemic inflammatory response syndrome and multiple organ failure. Blood Purif 1997; 15: 136–137.
Hffman JN, Deppisch R, Faist E, et al: Hemofiltration in human sepsis: evidence of elimination of immunomodulatory substances. Surg Forum 1994; 45: 69–71.
Bllomo R, Baldwin I, Cole L, Ronco C: Preliminary experience with high-volume hemofiltration in human septic shock. Kidney Int 1998; 54-I (Suppl 66): S182–S185.
Kine JA, Gordon BE, Williams C, et al: Large-pore hemodialysis in acute endotoxin shock. Crit Care Med 1999; 27: 588–596.
Dainaut JA, Vinsonneau C, Journois D: Hemofiltration and left ventricular function in sepsis: mechanisms and clinical implications. Crit Care Med 1999; 27: 473–474.
Oa S, Hirasawa H, Isono K: Tissue oxygen metabolism and cellular injury in patients with septic multiple organ failure. J Jpn Surg Soc 1993; 94: 556–563.
Reves JH, Butt WW: Blood filtration in children with severe sepsis: safe adjunctive therapy. Intensive Care Med 1995; 21: 500.
Hirasawa H, Sugai T, Ohtake Y, et al: Energy metabolism and nutritional support in anuric multiple organ failure patients. In: Tanaka T, Okada A (eds) Anuric Multiple Organ Failure Patients. Amsterdam, Elsevier, 1990; 429–440.
Hirasawa H, Sugai T, Ohtake Y, et al: Continuous hemofiltration and hemodiafiltration in the management of multiple organ failure. Contrib Nephrol 1991; 93: 42.
Belomo R, Farmer M, Wright C, Parkin G, Boyce N: Treatment of sepsis-associated severe acute renal failure with continuous hemodiafiltration: clinical experience and comparison with conventional dialysis. Blood Purif 1995; 13: 246.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2000 Springer Science+Business Media New York
About this chapter
Cite this chapter
Hirasawa, H., Baue, A.E. (2000). Blood Purification Therapy to Prevent or Treat MOF. In: Baue, A.E., Faist, E., Fry, D.E. (eds) Multiple Organ Failure. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-1222-5_49
Download citation
DOI: https://doi.org/10.1007/978-1-4612-1222-5_49
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4612-7049-2
Online ISBN: 978-1-4612-1222-5
eBook Packages: Springer Book Archive