Skip to main content

Blood Purification Therapy to Prevent or Treat MOF

  • Chapter
Multiple Organ Failure

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).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 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.

    Chapter  Google Scholar 

  2. 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.

    Article  Google Scholar 

  3. Baue AE, Hirasawa H: Editorial overview of the surgical patient. Curr Opin Crit Care 1997; 3: 279–285.

    Article  Google Scholar 

  4. 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.

    Google Scholar 

  5. 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.

    Article  PubMed  CAS  Google Scholar 

  6. 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.

    CAS  Google Scholar 

  7. 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.

    PubMed  CAS  Google Scholar 

  8. 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.

    Article  Google Scholar 

  9. 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.

    Article  PubMed  CAS  Google Scholar 

  10. 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.

    Article  PubMed  CAS  Google Scholar 

  11. 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.

    Google Scholar 

  12. Hffman JN, Deppisch R, Faist E, et al: Hemofiltration in human sepsis: evidence of elimination of immunomodulatory substances. Surg Forum 1994; 45: 69–71.

    Google Scholar 

  13. 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.

    Google Scholar 

  14. Kine JA, Gordon BE, Williams C, et al: Large-pore hemodialysis in acute endotoxin shock. Crit Care Med 1999; 27: 588–596.

    Article  Google Scholar 

  15. Dainaut JA, Vinsonneau C, Journois D: Hemofiltration and left ventricular function in sepsis: mechanisms and clinical implications. Crit Care Med 1999; 27: 473–474.

    Article  Google Scholar 

  16. 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.

    Google Scholar 

  17. Reves JH, Butt WW: Blood filtration in children with severe sepsis: safe adjunctive therapy. Intensive Care Med 1995; 21: 500.

    Article  Google Scholar 

  18. 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.

    Google Scholar 

  19. Hirasawa H, Sugai T, Ohtake Y, et al: Continuous hemofiltration and hemodiafiltration in the management of multiple organ failure. Contrib Nephrol 1991; 93: 42.

    PubMed  CAS  Google Scholar 

  20. 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.

    Article  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints 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

Publish with us

Policies and ethics