The Immunomodulatory Potential of Hemoadsorption in Burn Care.

BACKGROUND: Burns are a common injury affecting thousands of people worldwide each year. Clinical severity varies according to the total body surface area burned, which is in turn associated with morbidity and mortality. The management of a severe burn patient requires admission to a referral center. Patients with severe burns exhibit a complex and dysregulated immuno-inflammatory response. This leads to the loss of immune homeostasis, which is a source of infectious complications and organ dysfunctions. This loss of control of immune mechanisms plays a key role in the morbidity and mortality of severe burn patients.

SUMMARY: Currently, several strategies, such as hemoadsorption, have been developed to modulate this host response. Modern hemoadsorption is based on new highly biocompatible sorbent cartridges of neutral macroporous resin beads. We propose herein a review of the immune pathways in burn injury and the rationale and potential applications of extracorporeal blood purification techniques, such as hemoadsorption, in the management of burn patients.

KEY MESSAGES: Severe burns trigger an uncontrolled immuno-inflammatory response, leading to high morbidity and mortality. Immune homeostasis loss is central to complications such as infections and organ failure. Hemoadsorption may represent a potential therapeutic option to help modulate the immune response in burn patients.