体外细胞因子清除技术：文献系统评价。
Techniques of extracorporeal cytokine removal: a systematic review of the literature.
机构信息
Department of Intensive Care, Austin Hospital, Heidelberg, Vic., Australia.
出版信息
Blood Purif. 2012;33(1-3):88-100. doi: 10.1159/000333845. Epub 2012 Jan 13.
BACKGROUND AND AIMS
Attempts at achieving cytokine homeostasis include blood purification to deliver cytokine removal. Assessment of ex vivo studies for optimal operating conditions is a vital step.
METHODS
We conducted a systematic search for ex vivo studies on cytokine removal using known modalities of extracorporeal circulation. We selected 29 articles and analyzed data according to clearance, sieving coefficient, ultrafiltrate concentration and percentage removal.
RESULTS
We identified four main techniques for cytokine removal: standard techniques, high cut-off (HCO) techniques, adsorption techniques and combined plasma filtration adsorption. HCO hemofiltration (HCO/HF) showed greatest consistency in cytokine removal among all approaches. Mean albumin clearance with HCO filters was 3.74 ml/min.
CONCLUSION
Ex vivo data support the view that HCO/HF is the most consistently effective approach in terms of sieving and clearance. Further investigation of HCO/HF in randomized controlled trials in animal models and humans seems desirable.
背景与目的
实现细胞因子动态平衡的尝试包括血液净化以实现细胞因子清除。评估最佳操作条件的离体研究是至关重要的一步。
方法
我们对使用已知的体外循环方式进行细胞因子清除的离体研究进行了系统检索。我们选择了 29 篇文章，并根据清除率、筛系数、超滤浓度和百分比去除率来分析数据。
结果
我们确定了四种主要的细胞因子去除技术：标准技术、高截止（HCO）技术、吸附技术和联合血浆滤过吸附技术。HCO 血液滤过（HCO/HF）在所有方法中显示出对细胞因子去除的最大一致性。HCO 过滤器的白蛋白平均清除率为 3.74ml/min。
结论
离体数据支持 HCO/HF 在筛系数和清除率方面是最有效的方法。在动物模型和人类中进行随机对照试验进一步研究 HCO/HF 似乎是可取的。
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