Critical careにおけるCHDFのcytokine除去効果およびその機序について

概要

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Multiple organ failure (MOF) continues to be a main life-threatening condition during critical care. It has been claimed that an activated cascade of humoral mediators including cytokine plays a major role in the pathophysiology of MOF. We reported that the clearance of various cytokines with CHDF positively and significantly correlates to pre-CHDF blood levels of cytokines. The higher the cytokine blood level is, the larger its clearance with CHDF is. The removal of cytokines by CHDF seems to be mainly through the adsorption of cytokines to the hemofilter membrane. We also found that the blood levels of cytokines in patients whose pre-CHDF blood levels were high, decreased significantly with 3 consecutive days of CHDF but that the blood level of cytokines in patients whose pre-CHDF blood levels were low did not decrease with 3 consecutive days of CHDF. We also found that the degree of the decrease in the blood level of cytokines correlated significantly to the degree of improvement in organ dysfunction, indicating a clinical benefit of cytokine removal with CHDF. Therefore we conclude that CHDF can be applied for non-renal indications, aiming at the removal of causative humoral mediators such as cytokines.
日本アフェレシス学会の論文
1999-02-28