Blood Purification for Sepsis

Vincenzo Cantaluppi, Marita Marengo, Zhi Yong Peng, John A. Kellum, Rinaldo Bellomo, Claudio Ronco

Research output: Chapter in Book/Report/Conference proceedingChapter (Book)Otherpeer-review

2 Citations (Scopus)

Abstract

There is currently a clear biologic rationale for blood purification used in sepsis. Immunomodulation and organ support play important roles in the application of blood purification. Conventional continuous venovenous hemofiltration and hemodialysis have been shown not to be effective in sepsis in the absence of concomitant acute renal failure. Plasma therapies, high-volume hemofiltration, hemadsorption, or combinations of these therapies appear promising. However many questions still remain unanswered. Current technologies still remain inadequate for the removal of middle-molecular-weight substances, and the current practice worldwide is extremely variable. Moreover, there is lack of large-scale randomized clinical trials. Recently, new developing technologies may enhance the clinical results of current RRT strategies, including high-porosity of membranes to improve middle molecular clearance. Finally, multicenter randomized controlled trials are needed to test these promising blood purification technologies.

Original languageEnglish
Title of host publicationCritical Care Nephrology
EditorsClaudio Ronco, Rinaldo Bellomo, John A. Kellum, Zaccaria Ricci
Place of PublicationUnited States
PublisherElsevier
Chapter94
Pages548-552.e1
Number of pages6
Edition3rd
ISBN (Print)9780323449427
DOIs
Publication statusPublished - 2019

Keywords

  • Acute kidney injury
  • Blood purification
  • Hemifiltration
  • Hemoadsorption
  • Immunomodlation
  • Sepsis

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