多臓器不全とアフェレシス : アフェレシスの適応(<特集>多臓器不全とアフェレシス)

概要

論文の詳細を見る
Sepsis and septic shock remain the major cause of multiple organ dysfunction syndrome (MODS). Many attempts to treat MODS by single drug have been failed. Blood purifications using hemo (dia) filtration, plasma exchange or hemoadsorption has been clinically applied. Although definitive substances caused MODS have not been determined yet, endotoxin, anandamide or cytokines has been successfully decreased by some modalities of these blood purifications. Continuous renal replacement therapy (CRRT) has been used for critical ill patients with acute renal failure. Even though many studies show the plasma cytokine levels remain unchanged by CRRT, the removal of middle or large molecule by ultrafiltration, hemoadsorption or plasma exchange might be effective to treat sepsis or MODS. Plasma endotoxin and cytokines decreased after selective removal of endotoxin by Polymixin B-immobilized fiber. Recently new non-selective adsorbent for pro-and anti-inn1 amatory cytokines has developed. In this review, we will review animal studies and human clinical trial for the treatment of sepsis or MODS.
日本アフェレシス学会の論文
2004-02-29