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Septic shock with multiorgan failure: From conventional apheresis to adsorption therapies
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. (Dialysis Center North, Rostock, Germany)
Division of Nephrology, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia.
Division of Nephrology, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia.
2012 (English)In: Seminars in dialysis, ISSN 0894-0959, E-ISSN 1525-139X, Vol. 25, no 2, 171-175 p.Article in journal (Refereed) Published
Abstract [en]

Septic shock is often associated with multiorgan failure, a life threatening clinical condition during which there is an imbalance in the proinflammatory and anti-inflammatory cytokines, chemokines, antigens, endotoxins, procoagulant, and anticoagulant factors and also resultant effects of therapeutic intervention like volume overload. Various extracorporeal therapies have shown some positive results as adjunctive therapeutic intervention to traditional antimicrobials in an effort to bring the inflammatory mediators to a homeostatic balance and to improve poor organ perfusion caused by hypotension and thrombosis in the microcirculation. This review focuses on current information on the use of therapeutic apheresis procedures as adjunctive therapy in such clinical situations as well as the exciting prospects for the near future. The sometimes disappointing results of early phase clinical studies may, in some cases, be related to the well known barriers to successful clinical trials in critically ill patients rather than to failure of the novel concept of adjunctive extracorporeal treatment of septic shock. It should be noted that some of the specialized apheresis technologies reviewed in this article are not yet available for clinical use in the United States as they are not yet approved for use by the US Food and Drug Administration.

Place, publisher, year, edition, pages
2012. Vol. 25, no 2, 171-175 p.
National Category
Family Medicine
URN: urn:nbn:se:umu:diva-54335DOI: 10.1111/j.1525-139X.2011.01029.xISI: 000301710200010OAI: diva2:517672
Available from: 2012-04-24 Created: 2012-04-24 Last updated: 2012-04-24Bibliographically approved

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