高効率血液浄化療法(high flow-volume large size PMMA-HDF : High Performance HDF)(<特集>急性臓器障害に対するアフェレシス)

概要

論文の詳細を見る
We have reported that high flow dialysate and high volume filtrate hemodiafiltration using a polymethyl methacrylate (PMMA) membrane (high flow-volume large size PMMA-HDF : HP-HDF) may be useful in the treatment of critically ill patients. HP-HDF is a highly efficient blood purification method to remove pathologic substances such as inflammatory cytokines from blood, regardless of the presence of renal failure. It is well known that the PMMA membrane has the ability to absorb low molecular proteins. The PMMA membrane hemodialyzer has a large surface area of 2.1mm^2 and large pore size. In HP-HDF, the blood flow rate is 150ml/min, the dialysate flow rate is 400ml/min, and the filtration flow rate is 1, 500ml/h. HP-HDF is highly efficient in all of the three major principles of blood purification : diffusion, filtration and absorption. It is also high in cost performance. HP-HDF significantly decreased blood interleukin-6 (IL-6) and lactate levels in previously high patients. In ARDS patients, the P/F ratio showed a marked rise as early as an hour after the introduction of HP-HDF. In septic shock patients, the doses of catecholamine required to maintain blood pressure were reduced substantially. We have found that if treatment with HP-HDF is started before organ damage progresses, hypercytokinemia-induced pathophysiological conditions can be treated more efficiently.
日本アフェレシス学会の論文
2007-10-31