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Hemofiltration and inflammatory mediators
Daniel J Fitzgerald1, Giovanni Cecere
1Brigham and Women's Hospital, Boston, Massachusetts, USA.
Insights
Hemofiltration, used with cardiopulmonary bypass during cardiac surgery, helps manage the inflammatory response. This review covers its principles, strategies, and role in reducing mediators of systemic inflammatory response syndrome (SIRS).
Area of Science:
- Cardiovascular Surgery
- Critical Care Medicine
- Biomedical Engineering
Background:
- Hemofiltration has been utilized alongside cardiac surgery and cardiopulmonary bypass (CPB) since 1976.
- Its application in this setting has become a routine practice.
- The Systemic Inflammatory Response Syndrome (SIRS) is a significant concern in cardiac surgery patients.
Purpose of the Study:
- To review the fundamental principles of hemofiltration.
- To discuss strategies and optimal timing for hemofiltration during cardiac surgery.
- To examine the indications for hemofiltration and its role in mitigating SIRS mediators.
Main Methods:
- Literature review of hemofiltration principles and applications in cardiac surgery.
- Analysis of strategies and timing for hemofiltration implementation.
- Focus on hemofiltration's effect on plasma levels of SIRS mediators.
Main Results:
- Hemofiltration is an established technology in cardiac surgery with CPB.
- The review outlines key principles, strategic uses, and indications.
- Evidence suggests hemofiltration can reduce plasma levels of SIRS mediators.
Conclusions:
- Hemofiltration is a valuable adjunct in cardiac surgery with CPB.
- Understanding its principles and strategic application is crucial.
- Hemofiltration shows promise in managing the inflammatory cascade associated with CPB.
Abstract:
Hemofiltration used in conjunction with cardiac surgery and cardiopulmonary bypass (CPB) was first reported in 1976. Since then, the technology has been routinely used in this context. This review attempts to restate the basic principles governing hemofiltration, the strategies or timing of the use of the technology, and the indications. Particular attention will be focused on the role of hemofiltration in an attempt to reduce the plasma levels of some of the mediators of the Systemic Inflammatory Response Syndrome (SIRS).