Blood Purification by Hemofiltration in Septic Shock and Multiple Organ Dysfunction Syndrome Patients
In 1984 and 1986 Gotloib et al. [1, 2] published their positive experiences with intermittent hemofiltration in muhiple organ dysfunction syndrome (MODS) patients. The concept of blood purification by hemofiltration was received with a lot of scepticism, but nonetheless stimulated several research groups to analyze retrospective data and to perform prospective studies on this topic. Besides these chnical studies, a smah number of animal experimental studies have been performed. Undoubtedly, the high expectations with which the studies on the administration of monoclonal antibodies were welcomed as the therapy of the future diminished interest in the less prestigious hemofihration studies in MODS patients and animal models. It now seems reasonable to say that the use of monoclonals is promising and fascinating, but at the same time expensive and as yet of unproven value. The same holds for hemofiltration in this context; nonetheless, several centers have experience with this technique and use it routinely in therapy-resistant septic and cardiogenic shock. This chapter will describe the rationale for hemofiltration in shock and present an overview of the chnical and experimental studies performed so far; moreover, the limitations of the studies so far and ideas about future research wih be discussed.
KeywordsSeptic Shock Multiple Organ Dysfunction Syndrome Chronic Renal Failure Patient Blood Purification Continuous Venovenous Hemofiltration
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