重症急性膵炎に対する持続的血液濾過透析(CHDF)の有用性(<特集>肝・膵疾患とアフェレシス)

概要

論文の詳細を見る
It has been claimed that the activated cascade of humoral mediators including cytokine and granulocyte elastase plays a major role in the pathophysiology of SAP. Therefore, it is well acceptable that the main pathophysiology of SAP is systemic inflammatory response syndrome(SIRS)caused by the activated cascade of humoral mediators, and that this SIRS often develops multiple organ failure(MOF)during the course of SAP. In our experience, almost all patients with SAP had organ failure, which mainly consisted of respiratory and/or renal failure. On the other hand, previous clinical data from our laboratory clearly showed that continuous hemodiafiltration(CHDF)could effectively remove various humoral mediators from the blood stream of a patient. Therefore, we applied CHDF in the treatment of patients with SAP, aiming at the removal of causative humoral mediators. CHDF also effectively improved the respiratory index through the removal of causative humoral mediators of the increased permeability of alveolar membrane and resultant pulmonary interstitial edema in patients with SAP. CHDF was also very beneficial in the maintenance of water and electrolyte homeostasis. Thus, we conclude that CHDF is an inevitable therapeutic tool in the treatment of patients with SAP.
日本アフェレシス学会の論文
1997-10-31