Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.805
Filtrar
1.
Medicine (Baltimore) ; 99(9): e19058, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118713

RESUMO

Sepsis can cause septic shock, multiple organ dysfunction and even death. The combination of different blood purification would be the certain trend in the treatment of sepsis.This study was to evaluate the clinical effects of hemoperfusion (HP) combined with pulse high volume hemofiltration (PHVHF) on septic shock.Thirty cases were involved in this study and were randomly divided into two groups: HP and PHVHF group (n = 15) and CVVH (continuous veno-venous hemofiltration) group (n = 15). Acute physiology and chronic health evaluation (APACHE) II scores, sequential organ failure assessment (SOFA) scores as well as biochemical changes were measured before and after the treatment. The levels of IL-6, IL-10, and TNF-α in plasma were assessed by ELISA before and after treatment for 2 and 24 h. The norepinephrine doses were also analyzed. The 28-day mortalities in both groups were also compared.In both groups, body temperature (BT), respiratory rate (RR), white blood cells (WBC), C-reactive protein (CRP), Procalcitonin (PCT), lactic acid, serum creatinine, APACHE II scores and SOFA scores decreased after hemofiltration (P < .05). The HP&PHVHF group was superior to the CVVH group in CRP, APACHE II score (P < .01), and heart rate (HR), WBC, PCT, SOFA (P < .05). The doses of norepinephrine were also decreased after treatment (P < .01), with more reduction in the HP&PHVHF group (P < .05). After 24 h of treatment, the levels of IL-6, IL-10, and TNF-α decreased in both groups (P < .05), and the decrease was more significant in HP&PHVHF group (P < .05). In combined group, after 2 h of hemoperfison, there was a significant reduction in these inflammatory factors (P < .01). Combined therapy group's mortality was 26.7%, while CVVH group's was 40%.HP combined with PHVHF has a significant effect on septic shock and can be an important therapy for septic shock.


Assuntos
Hemofiltração , Hemoperfusão , Choque Séptico/terapia , Adulto , Idoso , Citocinas/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Choque Séptico/sangue
4.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(1): 31-36, 2020 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-31948521

RESUMO

OBJECTIVE: To study the clinical effect and complications of continuous blood purification (CBP) in the treatment of multiple organ dysfunction syndrome (MODS) in neonates. METHODS: A retrospective analysis was performed for the clinical data of 21 neonates with MODS who were admitted to the neonatal intensive care unit from November 2015 to April 2019 and were treated with CBP. Clinical indices were observed before treatment, at 6, 12, 24, and 36 hours of CBP treatment, and at the end of treatment to evaluate the clinical effect and safety of CBP treatment. RESULTS: Among the 21 neonates with MODS undergoing CBP, 17 (81%) had response to treatment. The neonates with response to CBP treatment had a significant improvement in oxygenation index at 6 hours of treatment, a significant increase in urine volume at 24 hours of treatment, a stable blood pressure within the normal range at 24 hours of treatment, and significant reductions in the doses of the vasoactive agents epinephrine and dopamine at 6 hours of treatment (P<0.05), as well as a significant reduction in serum K+ level at 6 hours of treatment, a significant improvement in blood pH at 12 hours of treatment, and significant reductions in blood lactic acid, blood creatinine, and blood urea nitrogen at 12 hours of treatment (P<0.05). Among the 21 neonates during CBP treatment, 6 experienced thrombocytopenia, 1 had membrane occlusion, and 1 experienced bleeding, and no hypothermia, hypotension, or infection was observed. CONCLUSIONS: CBP is a safe, feasible, and effective method for the treatment of MODS in neonates, with few complications.


Assuntos
Insuficiência de Múltiplos Órgãos , Gasometria , Nitrogênio da Ureia Sanguínea , Hemofiltração , Humanos , Recém-Nascido , Estudos Retrospectivos
5.
Medicine (Baltimore) ; 98(38): e17284, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31568012

RESUMO

BACKGROUND: This study will assess the efficacy and safety of blood purification (BP) for severe pancreatitis (SP) and acute respiratory distress syndrome (ARDS). METHODS: We will search the following electronic databases of Ovid MEDLINE, EMBASE, Web of Science, Cochrane Library, Scopus, Cumulative Index to Nursing and Allied Health Literature, the Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and WANGFANG from inception to the present without language restriction. A systematic review and data synthesis will be carried out of randomized controlled trials of BP for the treatment of patients with SP and ARDS. RevMan 5.3 software will be used for statistical analysis. RESULTS: This systematic review will evaluate the efficacy and safety of BP for the treatment of patients with SP and ARDS. The primary outcome includes respiratory indexes, blood biochemical and inflammatory factors. The secondary outcomes consist of complications, sepsis, abdominal hemorrhage, renal failure, length of hospital stay, and mortality. CONCLUSION: This study will provide up-to-date evidence of BP for the treatment of patients with SP and ARDS. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019139467.


Assuntos
Hemofiltração , Pancreatite/complicações , Síndrome do Desconforto Respiratório do Adulto/complicações , Doença Aguda , Hemofiltração/métodos , Humanos , Pancreatite/terapia , Síndrome do Desconforto Respiratório do Adulto/terapia , Resultado do Tratamento
6.
Medicine (Baltimore) ; 98(40): e17421, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577757

RESUMO

Regional citrate anticoagulation (RCA) was recommended as the first treatment option for adults by the Kidney Disease Improving Global Outcomes Kidney Foundation in 2012, for the characteristic of sufficient anticoagulation in vitro, but almost no anticoagulation in vivo. Traditionally, the substitute for RCA is calcium-free. This study investigated a simplified protocol of RCA for continuous hemofiltration (CHF) in children using a commercially available substitute containing calcium.An analytical, observational, retrospective study assessed 59 pediatric patients with 106 sessions and 3580 hours of CHF. Values before and after treatment were compared, including Na, ionic calcium (iCa) and HCO3 concentrations, pH, and the ratio of total calcium to iCa (T/iCa). In addition, in vivo and in vitro iCa, treatment time, sessions with continuous transmembrane pressure >200 mm Hg, and sessions with clotting and bleeding were recorded.The average treatment time was 33.8 ±â€Š10.1 hours. In vitro, 88.5% of iCa achieved the target (0.25-0.35 mmol/L), and in vivo, 95.4% of iCa achieved the target (1.0-1.35 mmol/L). There were 8 sessions with a transmembrane pressure >200 mm Hg and 3 sessions with filters clotted. After treatment, there were 2, 1, and 2 sessions with T/iCa > 2.5 (implying citrate accumulation), iCa < 0.9 mmol/L, and iCa > 1.35 mmol/L. No sodium disorders were recorded. There were fewer cases of acidemia and more cases of alkalemia after treatment compared to before.RCA-CHF with a substitute containing calcium and close monitoring could be a safe and effective treatment for children. In addition, the calcium test site in vitro and the adjustment of citrate should be given strict attention.


Assuntos
Lesão Renal Aguda/metabolismo , Lesão Renal Aguda/terapia , Anticoagulantes/farmacocinética , Cálcio/farmacocinética , Ácido Cítrico/farmacocinética , Hemofiltração , Lesão Renal Aguda/etiologia , Anticoagulantes/administração & dosagem , Cálcio/administração & dosagem , Criança , Pré-Escolar , Ácido Cítrico/administração & dosagem , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos
8.
Clin Nephrol ; 92(5): 243-249, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31448719

RESUMO

OBJECTIVE: To study the effects of early continuous veno-venous hemofiltration (CVVH) on organ function and intra-abdominal pressure (IAP) in severe acute pancreatitis (SAP) patients with abdominal compartment syndrome (ACS). MATERIALS AND METHODS: 48 SAP patients with ACS were included in this study. Among them, 37 patients, receiving both conventional treatment and hemofiltration therapy in the ICU, were regarded as the treatment group, and the rest, receiving only conventional treatment, were regarded as the control group. Symptoms, signs, and adverse reactions of both groups were observed and recorded during treatments. Serum and urine amylase, liver and kidney function, C-reactive protein, and intra-abdominal pressure of the patients were detected before and on days 1, 2, 3, 4, 5, and 6 after treatment. RESULTS: 1. Symptoms and signs in the treatment group disappeared quickly, and their hospitalization time was significantly shorter than those of control group (p < 0.05). 2. After treatment, on days 1, 2, 3, 4, 5, and 6, patients' serum and urine amylase levels, C-reactive protein, and intra-abdominal pressure were significantly lower, and liver and kidney function was significantly better than those of the control group (p < 0.05). CONCLUSION: Early hemofiltration in SAP with ACS can effectively reduce intra-abdominal pressure, improve symptoms, accelerate liver and renal function recovery, avoid multiple organ failure and decrease mortality rate.


Assuntos
Hemofiltração , Hipertensão Intra-Abdominal , Pancreatite , Adulto , Idoso , Feminino , Humanos , Hipertensão Intra-Abdominal/etiologia , Hipertensão Intra-Abdominal/fisiopatologia , Hipertensão Intra-Abdominal/terapia , Masculino , Pessoa de Meia-Idade , Pancreatite/complicações , Pancreatite/fisiopatologia , Pancreatite/terapia
9.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 31(6): 725-730, 2019 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-31315731

RESUMO

OBJECTIVE: To design a mathematical calculation model for better understanding and grasping the logical problem of replacement fluid and citric acid anticoagulant infusion in continuous veno-venous hemofiltration (CVVH). METHODS: (1) Parameter definition: A, B, and T were respectively called the main part of pre-replacement fluid, 5% sodium bicarbonate solution, and 4% sodium citrate infused before filter. And a and b were respectively called the main part of post-replacement fluid, and 5% sodium bicarbonate solution infused after filter. (2) Logic conversion: The liquid in back terminal (Z) was artificially divided into two parts. One (X) was the original residual plasma after filtration. The second (Y) was the part excluding the plasma, including the left part of pre-replacement fluid with sodium citrate, and the post-replacement fluid. (3) The mathematical formulas of liquid volume and electrolyte concentration at X, Y and Z in unit time were listed according to the principle of CVVH and the screening coefficient of filter for different substances. (4) The calculation formulas were entered into Excel form, and a mathematical calculation model was made, and a simulation calculation with examples was carried out. RESULTS: An Excel model was established by inserting the calculation formulas of volume, electrolyte, and total calcium at X, Y and Z. And it was found that the concentration of Na+, K+, Cl-, HCO3- at Y point remained unchanged only when A, B and (or) a, b was kept in same side and proportion even with the change of blood flow and other parameters without sodium citrate as anticoagulant. Once any of the parameters (such as blood flow, replacement fluid volume, etc.) were adjusted in other infusion methods (such as different ratios, different directions of the same year, etc.), the calculation results at Y would vary, and the electrolyte concentration at Z would change accordingly. A change of dilution model or parameter would result in the change of the electrolyte concentration at Y and Z with sodium citrate as anticoagulant. The concentration of total calcium scarcely changed no matter in what model and parameters. CONCLUSIONS: All kinds of infusion ways could be included in the Excel model. The infusion results of all kinds of infusion matching could be intuitively evaluated. It is helpful for the medical staff to make a logical analysis and risk prediction in CVVH.


Assuntos
Ácido Cítrico/administração & dosagem , Hemofiltração/métodos , Modelos Teóricos , Terapia de Substituição Renal , Anticoagulantes/administração & dosagem , Humanos , Citrato de Sódio/administração & dosagem
10.
Int J Antimicrob Agents ; 54(3): 351-355, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31279852

RESUMO

The aim of this study was to describe the population pharmacokinetics of ticarcillin during extended daily diafiltration (EDDf) in critically ill patients with acute kidney injury. Blood samples were collected from critically ill patients prescribed ticarcillin during one to two dosing intervals during which EDDf was performed. Plasma samples were measured using a validated ultra high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method. Concentration-time data were analysed using a population pharmacokinetics approach with Pmetrics®. A total of 53 blood samples were collected from six critically ill patients (three male). The mean ± standard deviation patient age, weight and body mass index (BMI) was 43 ± 22 years, 88 ± 14 kg and 31 ± 5 kg/m2, respectively. A two-compartment linear model adequately described the data. Median population pharmacokinetic parameter estimates were as follows: clearance in the presence of EDDf (CLEDDf), 6.41 L/h; clearance of EDDf (CLnon-EDDf), 4.97 L/h; volume of distribution of the central compartment (Vc), 56.46 L; intercompartmental clearance from the central to peripheral compartment (kCP), 13.54 L/h; and intercompartmental clearance from the peripheral to central compartment (kPC), 21.93 L/h. This is the first population pharmacokinetic model of ticarcillin in patients receiving EDDf. Large pharmacokinetic variability was found, supporting further investigation of the pharmacokinetics of less-studied ß-lactam antibiotics in prolonged intermittent renal replacement therapy.


Assuntos
Lesão Renal Aguda/terapia , Antibacterianos/farmacocinética , Estado Terminal , Hemofiltração/métodos , Ticarcilina/farmacocinética , Adulto , Idoso , Antibacterianos/administração & dosagem , Cromatografia Líquida , Feminino , Humanos , Masculino , Espectrometria de Massas , Pessoa de Meia-Idade , Plasma/química , Ticarcilina/administração & dosagem , Adulto Jovem
11.
J Coll Physicians Surg Pak ; 29(8): 785-787, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31358107

RESUMO

The objective of this study was to compare effects of octreotide and continuous hemofiltration versus continuous hemofiltration alone in the treatment of severe acute pancreatitis (SAP) complicated with acute respiratory distress syndrome (ARDS). It was an experimental study carried out from April 2016 to April 2018. A total of 86 cases of SAP complicated with ARDS were randomly divided into group A and group B, with 43 cases in each group. Group A was given continuous hemofiltration alone, and group B was given continuous hemofiltration combined with octreotide. The research findings showed that serum tumor necrosis factor (TNF-α), interleukin-1 (IL-1), IL-6, IL-8, diamine oxidase (DAO), endotoxin, D-lactic acid levels and acute physiology and chronic health evaluation (APACHE II) and systemic inflammatory response syndrome (SIRS) scores of group B were lower than those of group A (all p<0.001) after treatment. There was no significant difference in mortality between two groups after 90 days of discharge (p=0.306). Compared with continuous hemofiltration alone, treatment with continuous hemofiltration plus octreotide is higher in efficiency, but did not translate into improved mortality.


Assuntos
Fármacos Gastrointestinais/uso terapêutico , Hemofiltração , Octreotida/uso terapêutico , Pancreatite/complicações , Pancreatite/terapia , Síndrome do Desconforto Respiratório do Adulto/etiologia , APACHE , Adulto , Idoso , Biomarcadores/sangue , Citocinas/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
12.
Anesthesiology ; 131(3): 580-593, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31246600

RESUMO

BACKGROUND: Sepsis and septic shock are severe inflammatory conditions related to high morbidity and mortality. We performed a systematic review with meta-analysis of randomized trials to assess whether extracorporeal blood purification reduces mortality in this setting. METHODS: Electronic databases were searched for pertinent studies up to January 2019. We included randomized controlled trials on the use of hemoperfusion, hemofiltration without a renal replacement purpose, and plasmapheresis as a blood purification technique in comparison to conventional therapy in adult patients with sepsis and septic shock. The primary outcome was mortality at the longest follow-up available. We calculated relative risks and 95% CIs. The grading of recommendations assessment, development and evaluation methodology for the certainty of evidence was used. RESULTS: Thirty-seven trials with 2,499 patients were included in the meta-analysis. Hemoperfusion was associated with lower mortality compared to conventional therapy (relative risk = 0.88 [95% CI, 0.78 to 0.98], P = 0.02, very low certainty evidence). Low risk of bias trials on polymyxin B immobilized filter hemoperfusion showed no mortality difference versus control (relative risk = 1.14 [95% CI, 0.96 to 1.36], P = 0.12, moderate certainty evidence), while recent trials found an increased mortality (relative risk = 1.22 [95% CI, 1.03 to 1.45], P = 0.02, low certainty evidence); trials performed in the United States and Europe had no significant difference in mortality (relative risk = 1.13 [95% CI, 0.96 to 1.34], P = 0.15), while trials performed in Asia had a positive treatment effect (relative risk = 0.57 [95% CI, 0.47 to 0.69], P < 0.001). Hemofiltration (relative risk = 0.79 [95% CI, 0.63 to 1.00], P = 0.05, very low certainty evidence) and plasmapheresis (relative risk = 0.63 [95% CI, 0.42 to 0.96], P = 0.03, very low certainty evidence) were associated with a lower mortality. CONCLUSIONS: Very low-quality randomized evidence demonstrates that the use of hemoperfusion, hemofiltration, or plasmapheresis may reduce mortality in sepsis or septic shock. Existing evidence of moderate quality and certainty does not provide any support for a difference in mortality using polymyxin B hemoperfusion. Further high-quality randomized trials are needed before systematic implementation of these therapies in clinical practice.


Assuntos
Hemofiltração/mortalidade , Sepse/mortalidade , Sepse/terapia , Choque Séptico/mortalidade , Choque Séptico/terapia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
13.
Blood Purif ; 48(1): 18-24, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31039563

RESUMO

BACKGROUND: Recent innovations in biomaterials technology have led to the development of innovative sorbents adopted as adsorbing devices in the field of extracorporeal blood purification therapies. As removal mechanism, adsorption allows to remove specific molecules, selectively binding them to sorbent materials. In addition to the material properties, a quintessential aspect influencing device properties is blood flow distribution within the sorbent particles. OBJECTIVES: In order to adequately characterize the potential adsorbing properties for an effective blood purification therapy, an in vitro study assessing the fluid dynamics inside 3 new cartridges, HA130, HA230 and HA330 (Jafron, Zhuhai City, -China) was conducted through CT imaging technique. -Methods: The cartridges were placed in vertical position in the CT -gantry. Dye solution was circulated through the cartridges at 250 mL/min, longitudinal sections, 0.5 cm thick, were recorded for 60 s. Furthermore, an in vitro test was conducted to build pressure drop profiles. Blood was circulated at a different flow rate, 100-400 mL/min, step 50 mL/min. Pre and post cartridges pressures were acquired and pressure drop calculated. RESULTS: Sequential images demonstrated an excellent distribution of the flow inside the cartridges. Average flow velocity was 0.37 cm/s for the 3 cartridges. HA130 had a homogeneous flow profile along the entire length of the device; HA230 and HA330 showed minimal differences between central and peripheral regions. Pressure drop profiles resulted linear, increasing proportionally with blood flow rate and packing density. CONCLUSIONS: We may conclude that the structural and functional design of the studied cartridges is adequate for haemoperfusion with no channelling phenomena. This ensures maximum and optimal utilization of the sorbent contained in the devices.


Assuntos
Circulação Extracorpórea , Hemofiltração , Hidrodinâmica , Tomografia Computadorizada por Raios X , Circulação Extracorpórea/instrumentação , Circulação Extracorpórea/métodos , Hemofiltração/instrumentação , Hemofiltração/métodos , Humanos , Tomografia Computadorizada por Raios X/métodos
14.
Blood Purif ; 48(3): 196-202, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31039564

RESUMO

Extracorporeal blood purification techniques have emerged and evolved in the recent years as a potential therapy for the purpose of immunomodulation in acute conditions like sepsis. Understanding the extent of immune system dysregulation involved in the pathophysiology of these conditions, resulted in the development of such treatment strategies aiming at restoring a balanced inflammatory response. Beyond conventional continuous renal replacement therapy, high volume hemofiltration, high cut-off membranes, adsorption alone and coupled plasma filtration adsorption are well-described techniques in the literature. The evidence to support their routine use, however, is conflicting and insufficient at this stage. Despite the low-quality level of evidence in favor of utilizing these techniques, studies to further explore their effectiveness, safety, and potential novel applications, continue to evolve. Our review aims at focusing on adsorption therapy, particularly using the adsorption columns Cystosorb.


Assuntos
Adsorção , Circulação Extracorpórea/métodos , Imunomodulação , Hemofiltração/métodos , Humanos , Terapêutica
15.
Med Sci Monit ; 25: 3964-3975, 2019 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-31134957

RESUMO

BACKGROUND Studies have been carried out to assess the efficacy of high-volume hemofiltration (HVHF) among critically ill patients. However, it is currently unclear whether HVHF is really valuable in critically ill patients. MATERIAL AND METHODS Randomized controlled trials evaluating HVHF for critically ill adult patients were included in this analysis. Three databases were searched up to July 27, 2018. The relative risk (RR), mean difference (MD), and 95% confidence intervals (CI) were determined. RESULTS Twenty-one randomized controlled trials were included in this analysis. Overall, HVHF was associated with lower mortality compared with control measures (RR=0.88, 95% CI=0.81 to 0.96, P=0.004) in critically ill patients. Sub-analysis revealed HVHF reduced mortality in sepsis and acute respiratory distress syndrome patients, but no similar effect in other diseases. HVHF decreased levels of plasma tumor necrosis factor and interleukin 6. The heart rate of the HVHF group after treatment was slower than the control group, while we found higher mean arterial pressure in the HVHF group, but oxygenation index was not significantly different between the two groups. HVHF had no remarkable influence on acute physiological and chronic health evaluation score (APACHE II score) compared with the control group. CONCLUSIONS HVHF might be superior to conventional therapy in critically ill patients.


Assuntos
Estado Terminal/mortalidade , Estado Terminal/terapia , Hemofiltração/efeitos adversos , APACHE , Adulto , Pressão Arterial , Feminino , Frequência Cardíaca/fisiologia , Hemofiltração/métodos , Humanos , Unidades de Terapia Intensiva , Interleucina-6/sangue , Masculino , Pessoa de Meia-Idade , Síndrome do Desconforto Respiratório do Adulto/terapia , Sepse/terapia , Resultado do Tratamento , Fator de Necrose Tumoral alfa/sangue
20.
Crit Care ; 23(1): 108, 2019 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-30944029

RESUMO

BACKGROUND: Cardiopulmonary bypass (CPB) is often associated with degrees of complex inflammatory response mediated by various cytokines. This response can, in severe cases, lead to systemic hypotension and organ dysfunction. Cytokine removal might therefore improve outcomes of patients undergoing cardiac surgery. CytoSorb® (Cytosorbents, NJ, USA) is a recent device designed to remove cytokine from the blood using haemoadsorption (HA). This trial aims to evaluate the potential of CytoSorb® to decrease peri-operative cytokine levels in cardiac surgery. METHODS: We have conducted a single-centre pilot randomized controlled trial in 30 patients undergoing elective cardiac surgery and deemed at risk of complications. Patients were randomly allocated to either standard of care (n = 15) or CytoSorb® HA (n = 15) during cardiopulmonary bypass (CPB). Our primary outcome was the difference between the two groups in cytokines levels (IL-1a, IL-1b, IL-2, IL-4, IL-5, IL-6, IL-10, TNF-α, IFN-γ, MCP-1) measured at anaesthesia induction, at the end of CPB, as well as 6 and 24 h post-CPB initiation. In a consecutive subgroup of patients (10 in HA group, 11 in control group), we performed cross-adsorber as well as serial measurements of coagulation factors' activity (antithrombin, von Willebrand factor, factor II, V, VIII, IX, XI, and XII). RESULTS: Both groups were similar in terms of baseline and peri-operative characteristics. CytoSorb® HA during CPB was not associated with an increased incidence of adverse event. The procedure did not result in significant coagulation factors' adsorption but only some signs of coagulation activation. However, the intervention was associated neither with a decrease in pro- or anti-inflammatory cytokine levels nor with any improvement in relevant clinical outcomes. CONCLUSIONS: CytoSorb® HA during CPB was not associated with a decrease in pro- or anti-inflammatory cytokines nor with an improvement in relevant clinical outcomes. The procedure was feasible and safe. Further studies should evaluate the efficacy of CytoSorb® HA in other clinical contexts. TRIAL REGISTRATION: ClinicalTrials.gov NCT02775123 . Registered 17 May 2016.


Assuntos
Ponte Cardiopulmonar/efeitos adversos , Citocinas/efeitos adversos , Hemofiltração/instrumentação , Adulto , Idoso , Idoso de 80 Anos ou mais , Ponte Cardiopulmonar/métodos , Quimiocina CCL2/análise , Quimiocina CCL2/sangue , Citocinas/sangue , Citocinas/metabolismo , Feminino , Hemofiltração/métodos , Hemofiltração/normas , Humanos , Interleucina-10/análise , Interleucina-10/sangue , Interleucina-1alfa/análise , Interleucina-1alfa/sangue , Interleucina-1beta/análise , Interleucina-1beta/sangue , Interleucina-2/análise , Interleucina-2/sangue , Interleucina-4/análise , Interleucina-4/sangue , Interleucina-5/análise , Interleucina-5/sangue , Interleucina-6/análise , Interleucina-6/sangue , Masculino , Taxa de Depuração Metabólica , Pessoa de Meia-Idade , Projetos Piloto , Complicações Pós-Operatórias/prevenção & controle , Fator de Necrose Tumoral alfa/análise , Fator de Necrose Tumoral alfa/sangue
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA