The future of extracorporeal support

Dinna Cruz, Rinaldo Bellomo, John A. Kellum, Massimo De Cal, Claudio Ronco

Research output: Contribution to journalReview ArticleResearchpeer-review

26 Citations (Scopus)

Abstract

Extracorporeal therapy has expanded significantly over the past few decades from solely artificial renal replacement therapy. In patients with multiple organ dysfunction syndrome, it becomes necessary to provide multiple organ support therapy. Technological advances have opened the door to a multifaceted intervention directed at supporting the function of multiple organs through the treatment of blood. Indications for "old" therapies such as hemofiltration and adsorption have been expanded, and using these therapies in combination further enhances blood detoxification capabilities. Furthermore, new devices are constantly in development. Nanotechnology allows us to refine membrane characteristics and design innovative monitoring/biofeedback devices. Miniaturization is leading down the path of wearable/implantable devices. With the incorporation of viable cells within medical devices, these instruments become capable not only of detoxification but synthetic functions as well, bringing us closer to the holy grail of complete replacement of organ function. This article provides a brief overview of current and future direction in extracorporeal support in the critical care setting.

Original languageEnglish
JournalCritical Care Medicine
Volume36
Issue numberSUPPL. 4
DOIs
Publication statusPublished - 1 Jan 2008
Externally publishedYes

Keywords

  • Acute renal failure
  • Artificial membranes
  • Bioartificial
  • Continuous renal replacement therapy
  • Extracorporeal assist
  • Extracorporeal membrane oxygenation
  • Hemodialysis
  • Hemofiltration
  • Liver support
  • Multiorgan dysfunction syndrome
  • Nanotechnology

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