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Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy01:26

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Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in...
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Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...
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Hemoperfusion and hemofiltration are critical techniques in medical treatments to eliminate accumulated drugs, metabolites, and electrolytes from the bloodstream. These methods are particularly vital in cases of accidental poisoning and drug overdose.Hemoperfusion involves passing blood through an adsorbent material to remove unwanted substances. The main adsorbents used in hemoperfusion include activated charcoal and Amberlite resins. Activated charcoal can adsorb both polar and nonpolar...
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Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
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Ion exchange chromatography separates charged molecules from a solution by reversibly exchanging them with mobile, or 'active', ions associated with the oppositely charged stationary phase. This method can be used to separate ions, soften and deionize water, and purify solutions. The polymers comprising the ion-exchange column are high-molecular-weight and chemically stable polymers, crosslinked to be porous and essentially insoluble. They are also functionalized with either acidic or...
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Urgent therapeutic plasma exchange.

Samir Saheb1, Antonio Gallo1

  • 1Unité d'hémobiothérapie, APHP, Sorbonne Université, Hôpital De La Pitié-Salpêtrière, Paris, France.

Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis
|November 22, 2020
PubMed
Summary

Therapeutic plasma exchange (TPE) effectively removes inflammatory mediators for autoimmune disorders. This review details urgent TPE applications in neuromyelitis optica, organ transplantation, hypertriglyceridemia, and hyperthyroidism.

Keywords:
Plasma exchangeapheresisemergencyhypertrhyroidismhypertriglyceridemianeuromyelitis optica spectrum disordersorgan transplantation

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Area of Science:

  • Clinical Medicine
  • Immunology
  • Nephrology

Background:

  • Therapeutic plasma exchange (TPE) is a standard treatment for autoimmune diseases.
  • Its efficacy stems from removing inflammatory mediators like autoantibodies and cytokines.
  • Urgent TPE indications are limited but crucial.

Purpose of the Study:

  • To review the urgent applications of Therapeutic plasma exchange (TPE).
  • Focus on four critical conditions: neuromyelitis optica-spectrum disorders, solid organ transplantation, hypertriglyceridemia, and hyperthyroidism.
  • Discuss clinical urgency, treatment timing, protocols, and evidence.

Main Methods:

  • Literature review and clinical expertise synthesis.
  • Analysis of TPE's role in specific emergency settings.
  • Evaluation of evidence for each discussed condition.

Main Results:

  • TPE is vital in managing acute neuromyelitis optica-spectrum disorders.
  • It plays a critical role in post-solid organ transplantation complications.
  • Effective for severe hypertriglyceridemia and thyroid storm (hyperthyroidism).

Conclusions:

  • Urgent TPE offers life-saving interventions for specific, critical conditions.
  • Evidence supports TPE's use in these emergent scenarios.
  • Further research may expand urgent TPE indications.