Hemoperfusion with high-affinity polyethylene microbeads (Seraph-100®) for the removal of pathogens in chronic critically ill patients: Clinical experience.

Critically ill septic patients present variable clinical trajectories, with some succumbing to hyperinflammatory responses while others develop a chronic critical illness, characterized by a prolonged low-grade inflammation, muscle atrophy, and mechanical ventilation dependency and often develop secondary infections often caused by from low-virulence microorganisms or reactivated latent viruses. The Seraph-100® hemoperfusion cartridge takes advantage from heparin-coated ultra-high molecular weight polyethylene microbeads mimicking pathogen-binding cell receptors and can adsorb both pathogens and damage-associated molecular patterns released by injured tissues. We describe two chronic critically ill patients who developed secondary viral bloodstream infections successfully treated with this device.

SACS Evolution: a peristomal health tool for the prevention of peristomal skin disorders.

BACKGROUND: The ostomy patient's quality of life also depends on their peristomal health and thus first and foremost on keeping healthy peristomal skin. This is by no means an easy task, given that the incidence of peristomal skin disorders can be a factor in up to 80% of cases. Over the past 15 years, several tools have been developed to classify peristomal skin lesions to facilitate the management of the problem. These tools, however, meet the needs of healthcare professionals and those of patients. Hence the decision to work on an advanced version of the SACS©, currently the most widely used tool, with the setting up of the SACS Evolution Consensus Group. METHODS: By applying the simplified Delphi method, the SACS Evolution Consensus Group critically re-read what had been garnered from the literature in the light of their personal clinical experience, identified the key issues to be addressed, and processed and refined the relevant statements. This made it possible to achieve the challenging objective of creating a peristomal health tool to help prevent peristomal skin lesions. RESULTS: SACS Evolution is, indeed, a promising tool for preventing peristomal lesions. It is structured on two different levels, one for the patient and one for the healthcare professional, each characterized by specific language and based on an innovative concept of healthy peristomal skin, which is essential for those who work on peristomal health. CONCLUSIONS: The SACS Evolution Consensus Group thus aims to validate this peristomal health tool and has already started a validation process so that the tool can be used in clinical practice.