Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về y học đề tài: Hemofiltration, adsorption, sieving and the challenge of sepsis therapy design. | Critical Care October 2002 Vol 6 No 5 Honoré and Matson Commentary Hemofiltration adsorption sieving and the challenge of sepsis therapy design Patrick M Honoré1 and James R Matson2 Consultant in Intensive Care Medicine General Intensive Care Unit St Pierre Hospital Ottignies-Louvain-La-Neuve Belgium 2Consultant in Pediatric Critical Care Medicine Medical City Hospital Dallas Texas USA Correspondence Patrick M Honoré Pathonor@ and Published online 4 September 2002 Critical Care 2002 6 394-396 This article is online at http content 6Z5 394 2002 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract Circulating inflammatory mediators spilling into the circulation from sites of active inflammation are considered the source of remote tissue injury and associated organ dysfunction in sepsis. Hemofiltration has been proposed as a therapy for sepsis based on its ability to remove circulating inflammatory mediators by sieving or by adsorption or both. Designing devices and methods for sepsis therapy will require optimization of these two mechanisms. In the present issue of Critical Care Forum Kellum and Dishart report the relative effects of sieving and adsorption on plasma IL-6 following cecal ligation and puncture in rats. The authors conclude that hemoadsorption is the main mechanism of removal and discuss some possible implications for filter design but hemoadsorption is well dependant on hemofiltration the so-called hemofiltration filter adsorption synergistic effect . It is important to recognize the limitations of conventional systems Kellum and Dishart have extended our knowledge of hemofiltration filter adsorption which is quite different from conventional hemoadsorption. If sepsis is a manifestation of a nonlinear dynamic control system out of control then filtration at modest doses with a large pore filter may succeed as well as high-volume hemofiltration with a conventional cut-off filter.
