Header

UZH-Logo

Maintenance Infos

Extrakorporale Blutreinigungsverfahren in der Sepsis – Update


Seeliger, B; Stahl, K; David, Sascha (2020). Extrakorporale Blutreinigungsverfahren in der Sepsis – Update. Der Internist, 61(10):1010-1016.

Abstract

Background: Despite ongoing development, mortality in sepsis remains considerable. Various techniques for extracorporeal cytokine removal have been described, but evidence remains conflicting.
Objectives: The aim of this article is to summarize currently used extracorporeal blood purification techniques and their evidence.
Methods: Non-systematic literature review RESULTS: There are currently various blood purification techniques used with different levels of evidence regarding cytokine removal, vasopressor sparing effects and reduction of mortality, including high-volume dialysis with and without high cut-off filters, special adsorption filters (including CytoSorb®, CytoSorbents Europe, Berlin, Germany, and polymyxin‑B filters). There is development regarding therapeutic plasma exchange. For some blood purification techniques such as combined plasma filtration and adsorption, multicentric randomized studies found a negative effect on survival.
Conclusions: Despite a theoretical rationale, the use of blood purification methods cannot be recommended for sepsis patients due to the lack of evidence of their efficacy. Heterogeneous inflammatory responses in sepsis render conduction of larger trials difficult. Thus, future studies should cautiously identify appropriate sepsis subtypes to be included. Available techniques should be chosen as individualized complementary treatments and not as competing systems.

Abstract

Background: Despite ongoing development, mortality in sepsis remains considerable. Various techniques for extracorporeal cytokine removal have been described, but evidence remains conflicting.
Objectives: The aim of this article is to summarize currently used extracorporeal blood purification techniques and their evidence.
Methods: Non-systematic literature review RESULTS: There are currently various blood purification techniques used with different levels of evidence regarding cytokine removal, vasopressor sparing effects and reduction of mortality, including high-volume dialysis with and without high cut-off filters, special adsorption filters (including CytoSorb®, CytoSorbents Europe, Berlin, Germany, and polymyxin‑B filters). There is development regarding therapeutic plasma exchange. For some blood purification techniques such as combined plasma filtration and adsorption, multicentric randomized studies found a negative effect on survival.
Conclusions: Despite a theoretical rationale, the use of blood purification methods cannot be recommended for sepsis patients due to the lack of evidence of their efficacy. Heterogeneous inflammatory responses in sepsis render conduction of larger trials difficult. Thus, future studies should cautiously identify appropriate sepsis subtypes to be included. Available techniques should be chosen as individualized complementary treatments and not as competing systems.

Statistics

Citations

Dimensions.ai Metrics
2 citations in Web of Science®
2 citations in Scopus®
Google Scholar™

Altmetrics

Additional indexing

Other titles:Extracorporeal techniques for blood purification in sepsis: an update
Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Institute of Intensive Care Medicine
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Internal Medicine
Uncontrolled Keywords:Internal Medicine, Cytokines, proinflammatory; Hemodialysis; Hemofiltration; Plasma exchange; Shock, septic.
Language:German
Date:1 October 2020
Deposited On:20 Oct 2020 17:16
Last Modified:21 Oct 2020 20:01
Publisher:Springer
ISSN:0020-9554
OA Status:Closed
Publisher DOI:https://doi.org/10.1007/s00108-020-00862-5
PubMed ID:32897403

Download

Full text not available from this repository.
View at publisher

Get full-text in a library