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Renal Replacement Techniques in Septic Shock
Tapio Hellman1, Panu Uusalo2,3, Mikko J Järvisalo1,2,3
1Kidney Center, Turku University Hospital and University of Turku, Building 4, AA7, Kiinanmyllynkatu 4-8, FIN-20521 Turku, Finland.
International Journal of Molecular Sciences
|October 13, 2021
Summary
Sepsis causes life-threatening organ dysfunction and acute kidney injury (AKI). Extracorporeal therapies aim to remove inflammatory mediators in septic shock, but their benefits remain controversial.
Area of Science:
- Critical Care Medicine
- Nephrology
- Immunology
Background:
- Sepsis is a life-threatening condition causing organ dysfunction and high mortality.
- Sepsis is the primary cause of acute kidney injury (AKI) and need for renal replacement therapy (RRT) in intensive care units (ICUs).
- Septic shock involves a cytokine storm, leading to cellular toxicity, organ dysfunction, and increased mortality.
Purpose of the Study:
- To review the use of extracorporeal therapies for removing inflammatory mediators in septic shock.
- To evaluate the effectiveness of various adsorption techniques in improving patient outcomes.
Main Methods:
- Review of existing literature on extracorporeal adsorption techniques for sepsis.
- Examination of methods including high cut-off membranes, specific adsorption devices (e.g., Oxiris-AN69, CytoSorb, HA380), polymyxin B, and plasmapheresis.
Main Results:
- Extracorporeal adsorption techniques are explored to reduce cytokines and endotoxins during septic shock.
- These methods aim to mitigate early deleterious effects and improve patient outcomes.
- Data on the actual clinical benefits of these therapies remain controversial.
Conclusions:
- While RRT can treat AKI, its use for mediator adsorption in sepsis is under investigation.
- Various adsorption technologies show promise in managing the inflammatory response of septic shock.
- Further research is needed to confirm the definitive outcome benefits of these extracorporeal treatments in sepsis.
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