Although there has been continuous, intensive research for many years in the field of sepsis treatment, currently available treatment options are limited, and there is still a lack of systems that efficiently remove endotoxins as well as mediators. Here, we discuss a newly developed, integrated technique that combines different aspects for their use in extracorporeal blood purification for the supportive treatment of liver failure and sepsis.
LivigniS., BertoliniG., RossiC.; GiViTI: Gruppo Italiano per la Valutazione degli Interventi in Terapia Intensiva (Italian Group for the Evaluation of Interventions in Intensive Care Medicine) is an independent collaboration network of Italian Intensive Care units. Efficacy of coupled plasma filtration adsorption (CPFA) in patients with septic shock: a multicenter randomised controlled clinical trial. BMJ Open.2014; 4(1): e003536.
KellumJ.A., VenkataramanR., PownerD., ElderM., HergenroederG., CarterM.Feasibility study of cytokine removal by hemoadsorption in brain-dead humans. Crit Care Med.2008; 36(1): 268–272.
4.
DiLeoM.V., FisherJ.D., BurtonB.M., FederspielW.J.Selective improvement of tumor necrosis factor capture in a cytokine hemoadsorption device using immobilized anti-tumor necrosis factor. J Biomed Mater Res B Appl Biomater.2011; 96B(1): 127–133.
5.
SchefoldJ.C., von HaehlingS., CorsepiusM.A novel selective extracorporeal intervention in sepsis: immunoadsorption of endotoxin, interleukin 6, and complement-activating product 5a. Shock.2007; 28(4): 418–425.
Oudemans-van StraatenH.M.Citrate anticoagulation for continuous renal replacement therapy in the critically ill. Blood Purif.2010; 29(2): 191–196.
8.
HetzelG.R., SchmitzM., WissingH., RiesW., SchottG., HeeringP.J., IsgroF., KribbenA., HimmeleR., GrabenseeB., RumpL.C.Regional citrate versus systemic heparin for anticoagulation in critically ill patients on continuous venovenous haemofiltration: a prospective randomized multicentre trial. Nephrol Dial Transplant.2010; 26: 232–239.
9.
SchilderL., NurmohamedS.A., BoschF.H.; CASH study group. Citrate anticoagulation versus systemic heparinisation in continuous venovenous hemofiltration in critically ill patients with acute kidney injury: a multi-center randomized clinical trial. Crit Care.2014; 18(4): 472.
10.
SwartzR., PaskoD., OTooleJ., StarmannB.Improving the delivery of continuous renal replacement therapy using regional citrate anticoagulation. Clin Nephrol.2004; 61(2): 134–143.
11.
HarmS., FalkenhagenD., HartmannJ.Endotoxin adsorbents in extracorporeal blood purification: do they fulfill expectations?Int J Artif Organs.2014; 37(3): 222–232.
12.
FalkenhagenD., HarmS., HartmannJ.Dosing Instructions for Endotoxin-Binding Lipopeptides. International Patent Application. 2014; PCT/EP2013/063496, WO002014001444A1.
13.
HarmS., FalkenhagenD., HartmannJ.Pore size - a key property for selective toxin removal in blood purification. Int J Artif Organs.2014; 37(9): 668–678.
14.
HartmannJ., StroblK., FalkenhagenD.Anticoagulation in combined membrane/adsorption systems. Prilozi.2008; 29(2): 39–49.
15.
HartmannJ., StroblK., HarmS.Citrate vs Heparin Anticoagulation in Extracorporeal Liver Support: A Glimpse on Biocompatibility. 2nd World Congress on Targeting Liver Diseases. 2015; June 25–26, St Julians, Malta.
16.
StroblK., HartmannJ., WallnerM., BrandlM., FalkenhagenD.A target-oriented algorithm for citrate-calcium anticoagulation in clinical practice. Blood Purif.2013; 36(2): 136–145.
17.
WhitfieldL.R., LevyG.Permeability of human and rat red blood cells to citrate. Thromb Res.1981; 21(6): 681–684.
18.
HarmS., GaborF., HartmannJ.Low-dose polymyxin: an option for therapy of Gram-negative sepsis. Innate Immun.2016; 22(4): 274–283.
19.
HarmS., GaborF., HartmannJ.Characterization of Adsorbents for Cytokine Removal from Blood in an In Vitro Model. J Immunol Res.2015; 2015: 484736.
20.
HartmannJ., StroblK., FichtingerU., FalkenhagenD.Citrate anticoagulation and activation of the complement system. Int J Artif Organs.2006; 29(5): 538.
21.
StegmayrB., KlinkmannH.Dieter Falkenhagen (1942–2015): a multifaceted scientist. Int J Artif Organs.2015; 38(11): 617–623.
