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Systemic Immunomodulating Therapies for Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Systematic Review and Meta-analysis.

IMPORTANCE: Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are rare but severe adverse reactions with high mortality. The … steroids, intravenous immunoglobulins, cyclosporine, plasmapheresis, thalidomide, cyclophosphamide, hemoperfusion, tumor necrosis factor inhibitors, and granulocyte colony-stimulating factors. Glucocorticosteroids were associated with a survival benefit for patients in all 3 analyses but were statistically significant in only one (aggregated data: OR, 0.5; 95%% …

The international, prospective COSMOS (CytOSorb® TreatMent Of Critically Ill PatientS) Registry: results from the first 300 patients.

INTRODUCTION: Blood purification techniques are being investigated as adjunctive options in critically ill patients not only to treat severe … ore adsorbers. CS was integrated in conjunction with kidney replacement therapy (75.6%), standalone hemoperfusion (7.1%), intermittent hemodialysis (IHD; 10.6%), extracorporeal membrane oxygenation (ECMO; 3.9%), and sustained low-efficiency daily dialysis (SLEDD; 4.9%). At baseline, median (interquartile range, IQR) APACHE II and SOFA scores were 24 [18, 30] an …

Ischaemia-reperfusion injury in the isolated haemoperfused bovine uterus: an in vitro model of acute inflammation.

Following on from previous studies on dermal inflammation in the isolated perfused bovine udder, a new in vitro model of the isolated haemoperfused bovine uterus was established for studies on acute inflammatory reactions (for example, eicosanoid synthesis and regulation of cyclooxygenase-1 [COX-1] and COX-2) caused by ischaemia-reperfusion (I-R) injury. The organs and blood used in this study were obtained from a slaughterhouse. Within 2 hours of slaughter, uterine perfusion was re-established, by using a mixture of homologous blood and Tyrode solution (4:1). After equilibration, several depo

Successful Cases of Combined Treatment for WIfI Clinical Stage 4 Chronic Limb-Threatening Ischemia Using Popliteal-to-Distal Bypass, Minor Amputation, Debridement, and Rheocarna Therapy in Hemodialysis Patients: A Case Series.

Chronic limb-threatening ischemia (CLTI) is a severe form of lower extremity artery disease. CLTI is an umbrella term for conditions in which the lower limb is threatened by ischemia, tissue defects, neural disorders, or infection. In Japan, CLTI primarily affects patients with diabetes and those on hemodialysis. The severity of CLTI is assessed using the Wound, Ischemia, and foot Infection (WIfI) classification. CLTI needs multidisciplinary therapy. Rheocarna is a novel direct hemoperfusion device and can adsorb low-density lipoprotein (LDL) cholesterol and fibrinogen, thereby improving hemor…

Incidence and clinical characteristics of hypertriglyceridemic acute pancreatitis: A retrospective single-center study.

BACKGROUND: The incidence of hypertriglyceridemic acute pancreatitis (HTG-AP) has increased yearly, but updated population-based estimates on the incidence of HTG-AP are lacking. Reducing serum triglyceride (TG) levels quickly is crucial in the early treatment of HTG-AP. Decreased serum TG levels are treated by non-invasive methods, which include anti-lipidemic agents, heparin, low-molecular weight heparin, and insulin, and invasive methods, such as blood purification including hemoperfusion (HP), plasmapheresis, and continuous renal replacement therapy. However, authoritative guidelines have …

[An analysis of relevant factors of early death in acute paraquat poisoning].

OBJECTIVE: To determine the clinical indicators of early death (within 72 hours) in patients with acute paraquat poisoning. METHODS: The data of 93 acute paraquat poisoning patients admitted to emergency intensive care unit (EICU) of the First Hospital of China Medical University were retrospectively analyzed. The patients were divided into two groups according to whether they died within 72 hours or not. The gender, age, poison dose, paraquat concentration in urine, reduction of paraquat amount in urine after each hemoperfusion, and the worst value of white blood cell (WBC) count, lymphocyte…

Eighteen cases exposed to sarin in Matsumoto, Japan.

Forty-six patients who were exposed to sarin consulted our hospital because of darkness of vision, and ocular pain, vomiting, dyspnea and headaches on June 27 and 28, 1994. Eighteen patients were admitted and 4 of them were in the critical state. There were 6 features: 1) depression of plasma cholinesterase activity (17 of 18 patients, 94%), 2) hypokalemia (4/18, 22%), 3) depression of triglyceride (12/18, 67%), 4) hypocapnia (5/17, 29%), 5) partial pressure of oxygen (PaO2) <80 mmHg, or requirement of O2 inhalation (15/18, 83%), 6) white blood cells (WBC) >9,000 per mm3 (13/18, 72%). Seventee

Nephrology in Veterinary Medicine.

Veterinary nephrology is a specialized field of veterinary medicine providing a high level of care for animals with all types of kidney disease. Veterinarians complete extensive training to become board-certified in veterinary nephrology-urology. Companion animal nephrology is the most advanced field; however, all species are afflicted by a variety of renal disorders. Most naturally occurring animal kidney diseases have similar disorders found in people; where veterinary research is lacking, clinical management is often modified from standard of care in people. Veterinarians have become adept

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… Charcoal hemoperfusion often used to treat toxicities with an appropriate pharmacokinetic profile. 37 – 44 The first veterinary-specific extracorporeal platform is a hemoperfusion machine (Aimalojic); it may be used by many emergency hospitals that do not have an extracorporeal therapies service, thus … Activated carbon hemoperfusion and plasma adsorption. Adv Small Anim Care. 2021;2:131–142. doi: 10.1016/j.yasa.2021.07.010 44. Fick ME, Messenger KM, Vigani A. Efficacy of a single session in-series hemoperfusion and hemodialysis in the management of carprofen overdose in two dogs. …

Derivation and elimination of uremic toxins from kidney-gut axis.

Uremic toxins are chemicals, organic or inorganic, that accumulate in the body fluids of individuals with acute or chronic kidney disease and impaired renal function. More than 130 uremic solutions are included in the most comprehensive reviews to date by the European Uremic Toxins Work Group, and novel investigations are ongoing to increase this number. Although approaches to remove uremic toxins have emerged, recalcitrant toxins that injure the human body remain a difficult problem. Herein, we review the derivation and elimination of uremic toxins, outline kidney-gut axis function and relati

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… A hemoperfusion cartridge containing an adsorbent substance, such as activated charcoal or a resin, is used in this procedure to circulate blood extracorporeally. … Hemoperfusion (HP) is based on the mass separation of adsorbents. …

Effect of Primary and Secondary Beads of Carbon Enterosorbent on Haematological Parameters and Oxidative Stress Development Caused by Melphalan in Rats.

Background and Objectives: Side effects of anti-cancer drugs are usually accompanied by oxidative stress, including myelotoxicity. We evaluated the potential of oral highly activated micro-/macroporous carbon adsorbents (bulk density of 0.16 g/cm3, surface area calculation by Brunauer-Emmett-Teller model (SBET) > 2200 m2/g, derived from proprietary phenolic resin beads) to alleviate oxidative stress and myelotoxicity in rats. Materials and Methods: A single injection of cytostatic melphalan (L-PAM) at a dose of 4 mg/kg was used for modelling. Two forms of activated carbon were used: AC1-primar

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… Hemoperfusion, Plasmaperfusion and other Clinical Uses of General, Biospecific, Immuno and Leucocyte Adsorbents. Volume 4. World Scientific; Singapore: 1988. Macroporous polystyrene adsorbent resin and its application in hemoperfusion. 36. … Hemoperfusion, Plasmaperfusion and other Clinical Uses of General, Biospecific, Immuno and Leucocyte Adsorbents. Volume 4. World Scientific; Singapore: 2017. Adsorptive treatment of acute radiation sickness: past achievements and new prospects; pp. 245–256. 40. …

Aconite poisoning.

INTRODUCTION: Aconitine and related alkaloids found in the Aconitum species are highly toxic cardiotoxins and neurotoxins. The wild plant (e … d pressure, and tissue oxygenation by the early use of cardiopulmonary bypass. The role of charcoal hemoperfusion to remove circulating aconitine alkaloids is not established. CONCLUSIONS: Aconite roots contain aconitine, mesaconitine, hypaconitine, and other Aconitum alkaloids, which are known cardiotoxins and neurotoxins. Patients present predominantly with …

Septic Hyperinflammation-Is There a Role for Extracorporeal Blood Purification Techniques?

This manuscript investigates the role of extracorporeal blood purification techniques in managing septic hyperinflammation, a critical aspect of sepsis characterized by an uncontrolled immune response leading to multiorgan dysfunction. We provide an overview of sepsis, focusing on the dynamics of immune response, the involvement of neutrophils, and the role of the endothelium in the disease's progression. It evaluates the effectiveness of various blood purification methods, including high-cut-off membranes, high-volume hemofiltration, adsorption techniques, and albumin dialysis, in removing cy

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… Effectiveness of polymyxin B-immobilized hemoperfusion against sepsis and septic shock: A systematic review and meta-analysis. J. Crit. Care. 2021;63:187–195. doi: 10.1016/j.jcrc.2020.09.007. 41. … Early use of polymyxin B hemoperfusion in abdominal septic shock: The EUPHAS randomized controlled trial. JAMA. 2009;301:2445–2452. doi: 10.1001/jama.2009.856. 59. …

Treatment for calcium channel blocker poisoning: a systematic review.

CONTEXT: Calcium channel blocker poisoning is a common and sometimes life-threatening ingestion. OBJECTIVE: To evaluate the reported effect … fructose 1,6-diphosphate, PK 11195, or triiodothyronine. Case reports were only found for charcoal hemoperfusion, dialysis, intra-aortic balloon pump, Impella device and methylene blue. CONCLUSIONS: The treatment for calcium channel blocker poisoning is supported by low-quality evidence drawn from a heterogeneous and heavily biased literature. High-dose insul …

Middle Molecular Uremic Toxin and Blood Purification Therapy.

The purpose of blood purification therapy is to remove uremic toxins, and middle molecules (MMs) are a specific target. An MM is defined as a solute that passes through the glomerulus with a molecular weight in the range of 0.5-58 kDa, and new classifications of "small-middle 0.5-15 kDa," "medium-middle 15-25 kDa," and "large-middle 25-58 kDa" were proposed. In Japan, the removal of α1-microglobulin (αMG) in the large-middle range has been the focus, but a new theory of removal has been developed, emphasizing the antioxidant effect of αMG as a physiological function. Clinical proof of this mec

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… New adsorption column (Lixelle) to eliminate beta2-microglobulin for direct hemoperfusion. Ther. Apher. 1998;2:13–17. doi: 10.1111/j.1744-9987.1998.tb00067.x. 44. Shi Y., Tian H., Wang Y., Shen Y., Zhu Q., Ding F. … Combined Hemoperfusion-Hemodialysis in End-Stage Renal Disease Patients. Contrib. Nephrol. 2023;200:118–122. doi: 10.1159/000527953. …

[Analysis of the current application status of blood purification therapy in critically ill children].

OBJECTIVE: To analyze the clinical features, treatment mode selection, factors influencing prognosis and current clinical application of con … P treatment mode was continuous veno-venous hemodiafiltration [CVVHDF; 60.8% (240/395), followed by hemoperfusion [HP; 15.7% (62/395)], therapeutic plasma exchange [TPE; 9.1% (36/395)], and hybrid blood purification treatment [HBPT; 14.4% (57/395)]. The right internal jugular vein was the main vascular access [51.1% (202/395)], and systemic heparin anticoagulat …

Diagnosis and treatment of maple syrup disease: a study of 36 patients.

OBJECTIVE: To evaluate an approach to the diagnosis and treatment of maple syrup disease (MSD). METHODS: Family histories and molecular tes … on of enteral and parenteral nutrition were consistently higher than those reported for dialysis or hemoperfusion. Prevention of acute isoleucine, valine, and other plasma amino acid deficiencies by appropriate supplements allowed a sustained decrease of plasma leucine levels to the therapeutic range of 100 to 300 micromol/L, at which point dietary leucine was …

The Use of Extracorporeal Organ Support Therapies for Acute Kidney Injury in Cancer Patients.

Acute kidney injury (AKI) is a frequent and serious complication in patients with cancer, associated not only with increased morbidity and mortality, but also with the interruption or modification of anticancer therapy. In critically ill patients with cancer, AKI arises from a complex interplay of cancer-related, treatment-related, and patient-related factors, with many patients requiring renal replacement therapy (RRT) and admission to the intensive care unit (ICU). This narrative review summarizes the etiology of AKI in patients with cancer and discusses the role of extracorporeal organ supp

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… The golden hour of polymyxin B hemoperfusion in endotoxic shock: The basis for sequential extracorporeal therapy in sepsis Artif. Organs 2020 44 184 186 10.1111/aor.13550 31386769 PMC7003912 45. Scharf C. Liebchen U. Paal M. Irlbeck M. Zoller M. Schroeder I. … Early use of polymyxin B hemoperfusion in abdominal septic shock: The EUPHAS randomized controlled trial JAMA 2009 301 2445 2452 19531784 10.1001/jama.2009.856 52. Rolston K.V. Infections in Cancer Patients with Solid Tumors: A Review Infect. Dis. …

Use of therapeutic plasma exchange to treat nonsteroidal anti-inflammatory drug overdose in dogs.

BACKGROUND: Therapeutic plasma exchange (TPE) may be an effective technique for treatment of accidental nonsteroidal anti-inflammatory drug (NSAID) overdose, but information regarding the use of this technique in veterinary medicine is currently limited. OBJECTIVES: To evaluate the overall outcome for dogs with NSAID overdose treated with TPE and to determine if any presenting factors can predict or influence overall outcome. Secondary objectives included investigating TPE complications as well as the utility of other adjunctive treatments. ANIMALS: Eleven client-owned dogs presented for NSA

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… Also, the use of charcoal hemoperfusion and hemodialysis for ibuprofen toxicity in a dog 23 has been reported. … Nonsteroidal anti‐inflammatory medications are highly protein bound (98%‐99%) and have a small V d, 18 which makes them difficult to remove by hemodialysis alone, but are ideal candidates for TPE or charcoal hemoperfusion techniques. …

Hemoadsorption as a Supportive Strategy for Severe Toxicity Associated With Chimeric Antigen Receptor T-Cell Therapy: A Case Series.

RATIONALE & OBJECTIVE: To describe the use and effects of extracorporeal blood purification with hemoadsorption in managing severe complications after treatment with chimeric antigen receptor T-cells (CAR-T). STUDY DESIGN: Retrospective analysis of a case series. SETTING & PARTICIPANTS: Hematological department and intensive care unit from a single institution. Patients with hematological cancer who underwent CAR-T therapy between 2021 and 2023, developed severe toxicity, and were treated with hemoadsorption based on clinical indications. RESULTS: Of 48 patients, extracorporeal blood purifi

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… Hemoperfusion with CytoSorb as adjuvant therapy in critically ill patients with SARS-CoV2 pneumonia Blood Purif 50 4-5 2021 566 571 10.1159/000511725 33181508 PMC7705939 27 Cytosorbents Corporation CytoSorb Literature Database https://literature.cytosorb-therapy.com 28 Schädler D. Pausch C. …