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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 1999 June;65(6):419-26

lingua: Inglese

Present and ­future ­options in con­tin­u­ous ­renal replace­ment ther­a­pies of sep­sis and MOF

Tetta C. 2, Ronco C. 3, Brendolan A. 3, Irone M. 1, Digito A. 1, Cioffi M. 1, Piccinni P. 1, Dan M. 1, Inguaggiato P. 2, La Greca G. 3

1 Department Clinical and Laboratory Research, Bellco SpA - Mirandola (Modena);
2 Department of Nephrology, S. Bortolo Hospital - Vicenza;
3 Intensive Care Units, S. Bortolo Hospital - Vicenza


Conventional con­tin­u­ous extra­cor­po­real treat­ments ­such as hemo­fil­tra­tion and hemo­di­a­fil­tra­tion ­have not ­achieved sig­nif­i­cant reduc­tion in cyto­kine plas­ma lev­els, in ­spite of ­their increas­ing pop­u­lar­ity main­ly relat­ed to the unnec­es­sary ­fluid restric­tion there­by ren­der­ing ade­quate calor­ic ­intake pos­sible (Actualités Nephrologiques, 1994). This is main­ly due to ­reduced fil­tra­tion, to satur­abil­ity of the adsorp­tion-relat­ed phe­nom­e­na and to the ­absence of a con­vec­tive ­mass trans­fer. New approach­es ­have ­been ­more recent­ly intro­duced. The con­cept of ­blood pur­ifi­ca­tion has ­been ­amplied in ­some new inno­va­tive tech­niques ­that use non-selec­tive or selec­tive sor­bents. We ­will ­focus on the cri­te­ria ­used by oth­ers and us to ­assess the effi­cien­cy in ­vitro and in ani­mal mod­els of sep­sis of ­more recent­ly intro­duced non-selec­tive and selec­tive devic­es. Among the inno­va­tive tech­niques, modal­ities ­aimed at the plas­ma treat­ment ­will ­receive empha­sis. These modal­ities ­that are ­based on plas­ma fil­tra­tion ­with the use of dif­fer­ent sor­bents. The pre­lim­i­nary ­results ­obtained ­from ongo­ing clin­i­cal ­trials ­will be pre­sent­ed. We ­will ­also ­expand on the tech­ni­cal, bio­log­i­cal and clin­i­cal ­aspects ­that ­should be ­addressed in ­order to estab­lish a new modal­ity as inno­va­tive in the treat­ment of sep­sis.

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