Acute Blood Purification

1 - Cover [Seite 1]
2 - Contents [Seite 6]
3 - Preface [Seite 9]
4 - Introduction [Seite 10]
4.1 - References [Seite 12]
5 - Current Status [Seite 13]
5.1 - Current Status of Blood Purification in Critical Care in Japan [Seite 13]
5.1.1 - Abstract [Seite 13]
5.1.2 - Methods [Seite 14]
5.1.3 - Results [Seite 15]
5.1.4 - Discussion [Seite 16]
5.1.5 - Acknowledgement [Seite 18]
5.1.6 - References [Seite 18]
6 - Terminology and Indication [Seite 20]
6.1 - Terminology and Classification of Blood Purification in Critical Care in Japan [Seite 20]
6.1.1 - Abstract [Seite 20]
6.1.2 - Expressions of Blood Purification in Critical Care [Seite 21]
6.1.3 - Definitions of Continuous and Intermittent Therapies [Seite 22]
6.1.4 - Classification Based on the Purification Mode Using a Hemofilter [Seite 23]
6.1.5 - Classification of Blood Purification Based on the Blood Drawing and Returning Routes [Seite 23]
6.1.6 - Selection of CHD, CHF and CHDF Based on the Elimination Efficiency [Seite 24]
6.1.7 - Expressions Used when the Volume of Blood Purification Is Increased Intentionally above the Standard Level [Seite 25]
6.1.8 - Expressions Based on the Administration Route of Substitution Fluid [Seite 26]
6.1.9 - Terms used to Express Flow Rates [Seite 26]
6.1.10 - Classification and Expressions of Hemofilters [Seite 27]
6.1.11 - Conclusion [Seite 28]
6.1.12 - References [Seite 28]
6.2 - Indications for Blood Purification in Critical Care [Seite 30]
6.2.1 - Abstract [Seite 30]
6.2.2 - Blood Purification in Intensive Care Units [Seite 30]
6.2.3 - Indications for Blood Purification in ICU [Seite 31]
6.2.4 - Blood Purification for Hypercytokinemia and Sepsis [Seite 33]
6.2.5 - Future Perspectives [Seite 35]
6.2.6 - References [Seite 37]
7 - Acute Renal Failure [Seite 40]
7.1 - Acute Kidney Injury of Non-Septic Origin Requiring Dialysis Therapy [Seite 40]
7.1.1 - Abstract [Seite 40]
7.1.2 - Pathogenesis of AKI in Cardiovascular Surgery [Seite 40]
7.1.3 - Predictive Factors for the Risk of Postoperative Dialysis [Seite 41]
7.1.4 - Intraoperative Events [Seite 42]
7.1.5 - Postoperative Events [Seite 43]
7.1.6 - Beginning Dialysis Therapy [Seite 43]
7.1.7 - Conclusion [Seite 47]
7.1.8 - References [Seite 47]
7.2 - Septic Acute Renal Failure [Seite 49]
7.2.1 - Abstract [Seite 49]
7.2.2 - Pathophysiology [Seite 50]
7.2.3 - Therapy [Seite 51]
7.2.4 - References [Seite 53]
8 - Non-renal Indication [Seite 56]
8.1 - Non-Renal Indications for Continuous Renal Replacement Therapy: Current Status in Japan [Seite 56]
8.1.1 - Abstract [Seite 56]
8.1.2 - Blood Purification Advances in Japan [Seite 57]
8.1.3 - PMMA-CHDF [Seite 59]
8.1.4 - Plasma Diafiltration [Seite 59]
8.1.5 - Online CHDF [Seite 60]
8.1.6 - Cytokine-Adsorbing Column [Seite 60]
8.1.7 - Future Perspectives [Seite 60]
8.1.8 - References [Seite 61]
8.2 - Continuous Hemodiafiltration Using a Polymethyl Methacrylate Membrane Hemofilter for SevereAcute Pancreatitis [Seite 63]
8.2.1 - Abstract [Seite 63]
8.2.2 - Evaluation of the Magnitude of Hypercytokinemia in Patients with SAP [Seite 64]
8.2.3 - Criteria for Initiation of and Weaning from PMMA-CHDF [Seite 65]
8.2.4 - Effects of PMMA-CHDF on Blood IL-6 Level, Clinical Parameters and Outcome [Seite 68]
8.2.5 - Effects of PMMA-CHDF on Abdominal Compartment Syndrome [Seite 69]
8.2.6 - PMMA-CHDF as a Means of Cytokine Modulation [Seite 70]
8.2.7 - Conclusion [Seite 71]
8.2.8 - References [Seite 71]
8.3 - Blood Purification in Fulminant Hepatic Failure [Seite 73]
8.3.1 - Abstract [Seite 73]
8.3.2 - Purpose of Blood Purification [Seite 74]
8.3.3 - Hemodialysis and Hemofiltration [Seite 75]
8.3.4 - Plasmapheresis [Seite 76]
8.3.5 - Molecular Adsorbents Recirculating System [Seite 77]
8.3.6 - Bioartificial Liver Devices [Seite 77]
8.3.7 - Clinical Implementation of Blood Purification in Our Group [Seite 77]
8.3.8 - Conclusions [Seite 80]
8.3.9 - References [Seite 80]
8.4 - Treatment of Severe Sepsis and Septic Shock by CHDF Using a PMMA Membrane Hemofilter as a Cytokine Modulator [Seite 82]
8.4.1 - Abstract [Seite 82]
8.4.2 - Procedures in PMMA-CHDF for the Treatment of Severe Sepsis/Septic Shock [Seite 83]
8.4.3 - Cytokine-Removing Effects of PMMA-CHDF [Seite 84]
8.4.4 - Therapeutic Effects of Early Implementation of PMMA-CHDF in Septic Shock [Seite 84]
8.4.5 - Immunomodulatory Effects of Cytokine Removal by PMMA-CHDF on Immunocompetent Cells [Seite 87]
8.4.6 - Enhancement of the Cytokine-Removing Capacity of PMMA-CHDF to Cope with Refractory Septic Shock [Seite 89]
8.4.7 - Conclusion [Seite 89]
8.4.8 - References [Seite 90]
8.5 - Efficacy of Continuous Hemodiafiltration with a Cytokine-Adsorbing Hemofilter in the Treatment of Acute Respiratory Distress Syndrome [Seite 92]
8.5.1 - Abstract [Seite 92]
8.5.2 - Materials and Methods [Seite 93]
8.5.3 - Results [Seite 95]
8.5.4 - Discussion [Seite 98]
8.5.5 - Conclusions [Seite 100]
8.5.6 - References [Seite 100]
8.6 - Blood Purification for Intoxication [Seite 102]
8.6.1 - Abstract [Seite 102]
8.6.2 - Indications for Blood Purification [Seite 103]
8.6.3 - Approach to Protein-Binding Substances [Seite 105]
8.6.4 - Case Presentation [Seite 106]
8.6.5 - Conclusion [Seite 108]
8.6.6 - References [Seite 108]
9 - Current Progresses in Methodology in Blood Purification in Critical Care [Seite 109]
9.1 - Current Progress in Blood Purification Methods Used in Critical Care Medicine [Seite 109]
9.1.1 - Abstract [Seite 109]
9.1.2 - Application of Blood Purification in Critical Care [Seite 110]
9.1.3 - Characteristics of Blood-Purification Methods Used in Critical Care [Seite 114]
9.1.4 - References [Seite 118]
9.2 - Membrane Materials for Blood Purification in Critical Care [Seite 121]
9.2.1 - Abstract [Seite 121]
9.2.2 - Materials and Methods [Seite 122]
9.2.3 - Results and Discussion [Seite 124]
9.2.4 - Conclusions [Seite 127]
9.2.5 - References [Seite 127]
9.3 - Anticoagulation in Acute Blood Purification for Acute Renal Failure in Critical Care [Seite 128]
9.3.1 - Abstract [Seite 128]
9.3.2 - Indications for Acute Blood Purification in Critical Care Patients [Seite 129]
9.3.3 - Modalities in Acute Blood Purification for ARF and Their Anticoagulation [Seite 129]
9.3.4 - Anticoagulation in Acute Blood Purification for ARF [Seite 131]
9.3.5 - Unfractionated Heparin [Seite 131]
9.3.6 - LMW Heparin [Seite 133]
9.3.7 - Nafamostat Mesilate [Seite 133]
9.3.8 - References [Seite 134]
9.4 - Equipment and Monitoring in Continuous Renal Replacement Therapy [Seite 135]
9.4.1 - Abstract [Seite 135]
9.4.2 - Selection of the Console System in CRRT [Seite 135]
9.4.3 - Composition and Monitoring of the CRRT Console [Seite 136]
9.4.4 - Management of CRRT Console System [Seite 141]
9.4.5 - References [Seite 142]
9.5 - Cytokine Adsorbing Columns [Seite 143]
9.5.1 - Abstract [Seite 143]
9.5.2 - CytoSorb Cartridge [Seite 145]
9.5.3 - CYT-860-DHP [Seite 145]
9.5.4 - Lixelle Column [Seite 146]
9.5.5 - CTR-001 Column [Seite 147]
9.5.6 - MPCF-X [Seite 148]
9.5.7 - Discussion [Seite 148]
9.5.8 - References [Seite 149]
9.6 - Plasma Dia-Filtration for Severe Sepsis [Seite 151]
9.6.1 - Abstract [Seite 151]
9.6.2 - Patients and Methods [Seite 152]
9.6.3 - Results [Seite 154]
9.6.4 - Discussion [Seite 156]
9.6.5 - Acknowledgement [Seite 157]
9.6.6 - References [Seite 157]
9.7 - Application of Polymyxin B Convalently Immobilized Fiber in Patients with Septic Shock [Seite 159]
9.7.1 - Abstract [Seite 159]
9.7.2 - Designing PMX [Seite 160]
9.7.3 - Animal Experiments [Seite 161]
9.7.4 - Clinical Studies [Seite 161]
9.7.5 - Drawbacks of Treatment with PMX-F [Seite 164]
9.7.6 - RCT of Treatment with PMX-F in Patients with Sepsis [Seite 164]
9.7.7 - Conclusion [Seite 165]
9.7.8 - References [Seite 165]
9.8 - Special Considerations in Continuous Hemodiafiltration with Critically Ill Pediatric Patients [Seite 167]
9.8.1 - Abstract [Seite 167]
9.8.2 - Advantages of CHDF over Intermittent Hemodialysis [Seite 168]
9.8.3 - CHDF Conditions for Pediatric Patients [Seite 168]
9.8.4 - Efficacy and Indications for CHDF in Pediatric Patients [Seite 168]
9.8.5 - Problems of CHDF in Pediatric Patients [Seite 169]
9.8.6 - Countermeasures to Problems Associated with CHDF in Pediatric Patients [Seite 169]
9.8.7 - Conclusions [Seite 174]
9.8.8 - References [Seite 174]
10 - Controversies in Blood Purification in Critical Care [Seite 176]
10.1 - Selection of Modality in Continuous Renal Replacement Therapy [Seite 176]
10.1.1 - Abstract [Seite 176]
10.1.2 - Modality in Continuous Renal Replacement Therapy (CRRT) [Seite 176]
10.1.3 - Selection of Modality in CRRT: Survival in ICU Acute Renal Failure [Seite 177]
10.1.4 - Efficacy of CRRT in Other Conditions [Seite 178]
10.1.5 - Conclusions [Seite 180]
10.1.6 - References [Seite 180]
10.2 - Online CHDF System: Excellent Cost-Effectiveness for Continuous Renal Replacement Therapy with High Efficacy and Individualization [Seite 182]
10.2.1 - Abstract [Seite 182]
10.2.2 - Methods and Results [Seite 183]
10.2.3 - Discussion [Seite 186]
10.2.4 - Conclusion [Seite 188]
10.2.5 - References [Seite 189]
11 - New Technology [Seite 190]
11.1 - 'Super High-Flux' or 'High Cut-Off'Hemofiltration and Hemodialysis [Seite 190]
11.1.1 - Abstract [Seite 190]
11.1.2 - SHF/HCO Hemofiltration [Seite 191]
11.1.3 - Ex vivo Findings with SHF/HCO Membranes [Seite 192]
11.1.4 - Pilot Clinical Study of SHF/HCO Hemofiltration [Seite 193]
11.1.5 - Effect of SHF/HCO Membrane on Cellular Function [Seite 193]
11.1.6 - Albumin Loss and Safety Issues [Seite 194]
11.1.7 - HCO Hemodialysis [Seite 195]
11.1.8 - Another Therapeutic Target: HMGB-1 and SHF/HCO Membrane [Seite 196]
11.1.9 - Conclusions [Seite 197]
11.1.10 - References [Seite 197]
12 - Author Index [Seite 199]
13 - Subject Index [Seite 200]