Department of Anesthesiology and Critical Care Medicine, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon, France.
EA 7426, Pathophysiology of Injury-Induced Immunosuppression, Hospices Civils de Lyon-Biomérieux-University Claude Bernard Lyon 1, Lyon, France.
Contrib Nephrol. 2023;200:88-97. doi: 10.1159/000529294. Epub 2023 Jun 1.
Recent advances in the development of sorbent materials have enabled the development of hemoperfusion (HP). However, HP dose and prescription are not standardized and there is no consensus in clinical practice guidelines. Adequate prescription and modality are of utmost importance to ensure HP effectiveness. Although the main indication of CytoSorb®, HA330/380, polymyxin B, and Seraph® is sepsis, these devices may be beneficial in many other situations such as liver failure, rhabdomyolysis, pancreatitis, cardiopulmonary bypass, extensive burns, and trauma or to ensure antiplatelet therapy drug removal. They can be applied as stand-alone therapies or combined with renal replacement therapy. The usual prescribed blood flow varies between 100 and 700 mL/min. CytoSorb® sessions usually last 24 h and may be repeated up to 7 days, whereas HA330/380, polymyxin B, and Seraph® sessions usually last between 2 and 4 h and are repeated up to 3 days. Current clinical data are lacking to establish the optimal operating conditions of HP and studies focusing on defining the optimal timing, dose, and duration of these therapies could help define future clinical applications.
吸附剂材料的最新进展使血液灌流（HP）得以发展。然而，HP 的剂量和处方尚未标准化，临床实践指南也没有共识。适当的处方和模式对于确保 HP 的有效性至关重要。虽然 CytoSorb®、HA330/380、多粘菌素 B 和 Seraph®的主要适应证是败血症，但这些设备在许多其他情况下也可能有益，如肝衰竭、横纹肌溶解症、胰腺炎、心肺旁路、广泛烧伤和创伤，或确保抗血小板治疗药物的清除。它们可以单独使用或与肾脏替代疗法联合使用。通常规定的血流在 100 至 700 毫升/分钟之间。CytoSorb® 疗程通常持续 24 小时，最多可重复 7 天，而 HA330/380、多粘菌素 B 和 Seraph® 疗程通常持续 2 至 4 小时，最多可重复 3 天。目前缺乏确定 HP 最佳运行条件的临床数据，而专注于定义这些治疗最佳时机、剂量和持续时间的研究可能有助于确定未来的临床应用。
