Methods of Molecular Transfusion in the Intensive Therapy of Critical States

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Abstract


Development of extracorporeal blood purification acquires greater significance in the intensive care of multiple organ failures (MOF) with all the pathophysiological aspects of its constituent parts. MOF are the main cause of mortality among critically ill patients and treatment of these patients require significant investment. The purpose of the implementation of extracorporeal blood correction techniques today is multiple organ support therapy (MOST). Early extracorporeal therapy is used only in the treatment of renal failure. Today extracorporeal techniques are increasingly being used to replace the functions of various organs and systems. MOST includes diffusion, convection, filtration, sorption, apheresis methodic. They affect the molecular and electrolyte composition of blood, allow to correct, repair, replace, and maintain homeostasis in severe multiorgan dysfunction. Extracorporeal new molecular technologies have been successfully applied in the intensive care of severe heart and respiratory failure, acute kidney injury and acute hepatic dysfunction, in the treatment of severe sepsis, metabolic disorders, the correction of immune imbalance.


M. B. Yaroustovsky

Bakoulev Scientifi c Center for Cardiovascular Surgery, Moscow, Russian Federation

Author for correspondence.
Email: mbyar@yandex.ru

Russian Federation

доктор медицинских наук, профессор, заведующий отделением гравитационной хирургии крови и эндоскопии ФГБУ НЦССХ Адрес: 121552, Москва, Рублевское шоссе, д. 135, тел.: +7 (495) 414-75-68

M. V. Abramyan

Bakoulev Scientifi c Center for Cardiovascular Surgery, Moscow, Russian Federation

Email: mar-abr@rambler.ru

Russian Federation

кандидат медицинских наук, ведущий научный сотрудник отделения гравитационной хирургии крови и эндоскопии ФГБУ НЦССХ Адрес: 121552, Москва, Рублевское шоссе, д. 135, тел.: +7 (495) 414-75-03

N. P. Krotenko

Bakoulev Scientifi c Center for Cardiovascular Surgery, Moscow, Russian Federation

Email: npkrotenko@bakulev.ru

кандидат медицинских наук, врач-анестезиолог-реаниматолог отделения гравитационной хирургии крови и эндоскопии ФГБУ НЦССХ Адрес: 121552, Москва, Рублевское шоссе, д. 135, тел.: +7 (495) 414-75-02

E. V. Komardina

Bakoulev Scientifi c Center for Cardiovascular Surgery, Moscow, Russian Federation

Email: nesluchainost@mail.ru

младший научный сотрудник отделения гравитационной хирургии крови и эндоскопии ФГБУ НЦССХ Адрес: 121552, Москва, Рублевское шоссе, д. 135, тел.: +7 (495) 414-75-03

  1. Рагимов А.А. Настоящее, проблемы и перспективы трансфузиологии // Вестник РАМН. ― 2012. – Т. 67. ― №10. ― С. 70–76. [Ragimov AA. The state of art, problems and future of transfusiology. Annals of the Russian Academy of Medical Sciences. 2012;67(10):70–76. (In Russ).] doi: 10.15690/vramn.v67i10.419.
  2. Bellomo R, Kellum JA, Ronco C. Acute kidney injury. Lancet. 2012;380(9843):756–766. doi: 10.1016/S0140-6736(11)61454-2.
  3. Uchino S, Kellum JA, Bellomo R, et al. Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA. 2005;294(7):813–818. doi: 10.1001/jama.294.7.813.
  4. Bellomo R, Ronco C. Continuous renal replacement therapy: hemofiltration, hemodiafiltration or hemodialysis. In: Ronco C, Bellomo R, Kellum JA, editors. Critcal care nephrology. 2nd ed. Philadelphia: Saunders Elsevier; 2009. p. 1354–1358.
  5. Hoste EA, Kellum JA. Incidence, classification, and outcomes of acute kidney injury. Contrib Nephrol. 2007;156:32–38. doi: 10.1159/000102013.
  6. Palevsky PM. Renal replacement therapy in acute kidney injury. Adv Chronic Kidney Dis. 2013;20(1):76–84. doi: 10.1053/j.ackd.2012.09.004.
  7. Ronco C, Ricci Z, De Backer D, et al. Renal replacement therapy in acute kidney injury: controversy and consensus. Crit Care. 2015;19:146. doi: 10.1186/s13054-015-0850-8.
  8. Ярустовский М.Б., Григорьянц Р.Г., Страхов Д.Г., и др. Современный вариант заместительной почечной терапии у больных с синдромом полиорганной недостаточности после операций на сердце и сосудах // Анестезиология и реаниматология. ― 2002. ― №1. ― С. 49–54. [Yaroustovsky MB, Grigor’yants RG, Strakhov DG, et al. Sovremennyi variant zamestitel’noi pochechnoi terapii u bol’nykh s sindromom poliorgannoi nedostatochnosti posle operatsii na serdtse i sosudakh. Anesteziol Reanimatol. 2002;(1):49– 54. (In Russ).]
  9. Бабаев M.А. Синдром полиорганной недостаточности после сердечно-сосудистых операций в условиях искусственного кровообращения: дис. … докт. мед. наук. ― М.; 2011. ― 255 с. [Babaev MA. Sindrom poliorgannoi nedostatochnosti posle serdechnososudistykh operatsii v usloviyakh iskusstvennogo krovoobrashcheniya. [dissertation]. Moscow; 2011. 255 p. (In Russ).]
  10. Saliba F, Camus C, Durand F, et al. Albumin dialysis with a noncell artificial liver support device in patients with acute liver failure: a randomized, controlled trial. Ann Intern Med. 2013;159(8):522– 531. doi: 10.7326/0003-4819-159-8-201310150-00005.
  11. Stange J, Hassanein TI, Mehta R, et al. The molecular adsorbents recycling system as a liver support system based on albumin dialysis: a summary of preclinical investigations, prospective, randomized, controlled clinical trial, and clinical experience from 19 centers. Artif Organs. 2002;26(2):103–110. doi: 10.1046/j.1525-1594.2002.06822.x.
  12. Oppert M, Rademacher S, Petrasch K, Jorres A. Extracorporeal liver support therapy with Prometheus in patients with liver failure in the intensive care unit. Ther Apher Dial. 2009;13(5):426– 430. doi: 10.1111/j.1744-9987.2009.00761.x.
  13. Гептнер Р.А. Альбуминовый диализ в интенсивной терапии больных с синдромом полиорганной недостаточности после операций на сердце и сосудах: дис…. канд. мед. наук. ― М.; 2009. ― 169 с. [Geptner RA. Al’buminovyi dializ v intensivnoi terapii bol’nykh s sindromom poliorgannoi nedostatochnosti posle operatsii na serdtse i sosudakh. [dissertation]. Moscow; 2009. 169 p. (In Russ).]
  14. Evenepoel P, Laleman W, Wilmer A, et al. Detoxifying capacity and kinetics of Prometheus a new extracorporeal system for the treatment of liver failure. Blood Purif. 2005;23(5):349–358. doi: 10.1159/000086885.
  15. Krisper P, Stauber RE. Technology insight: artificial extracorporeal liver support--how does Prometheus compare with MARS? Nat Clin Pract Nephrol. 2007;3(5):267–276. doi: 10.1038/ncpneph0466.
  16. Ярустовский М.Б., Абрамян М.В., Комардина Е.В., и др. Экстракорпоральные методы гемокоррекции при острой печеночной недостаточности у пациентов после кардиохирургических вмешательств // Анестезиология и реаниматология. ― 2014. ― Т. 59. ― №5 ― С. 4–10. [Yaroustovsky MB, Abramyan MV, Komardina EV, et al. Artificial liver support devices in patients with acute liver failure after cardiac surgery. Anesteziol Reanimatol. 2014;59(5):4–10. (In Russ).]
  17. Meijers BK, Verhamme P, Nevens F, et al. Major coagulation disturbances during fractionated plasma separation and adsorption. Am J Transplant. 2007;7(9):2195–2199. doi: 10.1111/j.1600- 6143.2007.01909.x.
  18. Gong D, Ji D, Zhu D, et al. Efficient removal of serum bilirubin by a novel artificial liver support system using albumin convection: a pilot study. Blood Purif. 2012;34(3-4):201–208. doi: 10.1159/000342111.
  19. Senturk E, Esen F, Ozcan PE, et al. The treatment of acute liver failure with fractionated plasma separation and adsorption system: Experience in 85 applications. J Clin Apher. 2010;25(4):195–201. doi: 10.1002/jca.20238.
  20. Donati G, La Manna G, Cianciolo G, et al. Extracorporeal detoxification for hepatic failure using molecular adsorbent recirculating system: depurative efficiency and clinical results in a long-term follow- up. Artif Organs. 2014;38(2):125–134. doi: 10.1111/aor.12106.
  21. Grodzicki M, Kotulski M, Leonowicz D, et al. Results of treatment of acute liver failure patients with use of the prometheus FPSA system. Transplant Proc. 2009;41(8):3079–3081. doi: 10.1016/j. transproceed.2009.08.024.
  22. Kaukonen KM, Bailey M, Suzuki S, et al. Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000-2012. JAMA. 2014;311(13):1308– 1316. doi: 10.1001/jama.2014.2637.
  23. Marshall JC. Endotoxin in the pathogenesis of sepsis. Contrib Nephrol. 2010;167:1–13. doi: 10.1159/000315914.
  24. Zhou F, Peng Z, Murugan R, Kellum JA. Blood purification and mortality in sepsis: a meta- analysis of randomized trials. Crit Care Med. 2013;41(9):2209–2220. doi: 10.1097/CCM.0b013e31828cf412.
  25. Yaroustovsky M, Abramyan M, Krotenko N, et al. A pilot study of selective lipopolysaccharide adsorption and coupled plasma filtration and adsorption in adult patients with severe sepsis. Blood Purif. 2015;39(1–3):210–217. doi: 10.1159/000371754.
  26. Yaroustovsky M, Abramyan M, Krotenko N, et al. Combined extracorporeal therapy for severe sepsis in patients after cardiac surgery. Blood Purif. 2014;37(1):39–46. doi: 10.1159/000357015.
  27. Berlot G, Agbedjro A, Tomasini A, et al. Effects of the volume of processed plasma on the outcome, arterial pressure and blood procalcitonin levels in patients with severe sepsis and septic shock treated with coupled plasma filtration and adsorption. Blood Purif. 2014;37(2):146–151. doi: 10.1159/000360268.
  28. Haase M, Bellomo R, Baldwin I, et al. Hemodialysis membrane with a high-molecular-weight cutoff and cytokine levels in sepsis complicated by acute renal failure: a phase 1 randomized trial. Am J Kidney Dis. 2007;50(2):296–304. doi: 10.1053/j.ajkd.2007.05.003.
  29. Rimmele T, Kellum JA. Clinical review: blood purification for sepsis. Crit Care. 2011;15(1):205. doi: 10.1186/cc9411.
  30. Formica M, Olivieri C, Livigni S, et al. Hemodynamic response to coupled plasmafiltration- adsorption in human septic shock. Intensive Care Med. 2003;29(5):703–708. doi: 10.1007/s00134- 003-1724-0.
  31. Lee D, Haase M, Haase-Fielitz A, et al. A pilot, randomized, double-blind, cross-over study of high cut-off versus highflux dialysis membranes. Blood Purif. 2009;28(4):365-372. doi: 10.1159/000235961.
  32. Morgera S, Haase M, Kuss T, et al. Pilot study on the effects of high cutoff hemofiltration on the need for norepinephrine in septic patients with acute renal failure. Crit Care Med. 2006;34(8):2099– 2104. doi: 10.1097/01.CCM.0000229147.50592.F9.
  33. Naka T, Haase M, Bellomo R. ‘Super high-flux’ or ‘high cut-off’ hemofiltration and hemodialysis. Contrib Nephrol. 2010;166:181– 189. doi: 10.1159/000314871.
  34. Ярустовский М.Б., Абрамян М.В., Кротенко Н.П., и др. Новая концепция сочетанного применения экстракорпоральных методов гемокоррекции в комплексной интенсивной терапии тяжелого сепсиса у пациентов после кардиохирургических операций // Анестезиология и реаниматология. ― 2015. ― Т. 60. ― №5. ― С. 75–80. [Yaroustovsky MB, Abramyan MV, Krotenko NP, et al. The new concept of combined use of extracorporeal blood correction in complex intensive therapy of severe sepsis in patients after cardiac surgery. Anesteziol Reanimatol. 2015;60(5):75–80. (In Russ).]
  35. Ярустовский М.Б., Абрамян М.В., Кротенко Н.П. и др. Этиопатогенетическая экстракорпоральная терапия тяжелого сепсиса у пациентов после кардиохирургических операций // Анестезиология и реаниматология. ― 2013.― №5. ― С. 34–41. [Yaroustovsky MB, Abramyan MV, Krotenko NP, et al. Etiopathogenetic extracorporeal treatment of severe sepsis in patients after cardiac surgery. Anesteziol Reanimatol. 2013;(5):34–41. (In Russ).]

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