'Super High-Flux' or 'High Cut-Off' Hemofiltration and Hemodialysis
'Super High-Flux' or 'High Cut-Off' Hemofiltration and Hemodialysis
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DOI：
10.1159/000314871
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发表时间：
2010-01-01
期刊：
影响因子：
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通讯作者：
Bellomo, Rinaldo
中科院分区：
文献类型：
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作者：
Naka, Toshio;Haase, Michael;Bellomo, Rinaldo
最近，已经开发了“超高通量”（SHF）或“高截留”（HCO）膜来增加炎症介质的清除。在实验和临床环境中，SHF/HCO膜似乎比传统的高通量膜实现更大的炎症细胞因子清除。SHF/HCO膜还恢复免疫细胞功能，减轻血流动力学不稳定性并降低血浆IL-6水平。此外，SHF/HCO膜可以消除较大的晚期炎症介质，如HMGB-1。尽管SHF/HCO膜的白蛋白筛分系数大于传统高通量膜，但每日损失量有限，可以更换。使用SHF/HCO膜的血液透析也可以实现与血液滤过相似的细胞因子清除，白蛋白损失可接受。当脓毒症或全身性炎症治疗策略靶向中分子介质时，SHF/HCO血液滤过和血液透析似乎都是可行和安全的，需要进一步的临床研究。版权所有（C）2010 S. Karger AG，巴塞尔
Recently, 'super high-flux' (SHF) or 'high cut-off' (HCO) membranes have been developed to increase the clearance of inflammatory mediators. In the experimental and clinical settings, SHF/HCO membranes appear to achieve greater clearance of inflammatory cytokines than conventional high-flux membranes. SHF/HCO membranes also restore immune cell function, attenuate hemodynamic instability and decrease plasma IL-6 levels. Moreover, SHF/HCO membranes can eliminate larger late-phase inflammatory mediators such as HMGB-1. Although albumin sieving coefficients with SHF/HCO membranes are greater than with conventional high-flux membranes, the daily amount lost is limited and can be replaced. Hemodialysis with SHF/HCO membranes can also achieve similar cytokine removal to hemofiltration with acceptable albumin losses. When strategies for sepsis or systemic inflammation treatment target middle molecular mediators, both SHF/HCO hemofiltration and hemodialysis appear feasible and safe and require further clinical investigation. Copyright (C) 2010 S. Karger AG, Basel