Shen Yingjing
Department of Nephrology, Shanghai Tianyou Hospital, Shanghai, China.
SAGE Open Med Case Rep. 2024 Aug 22;12:2050313X241272670. doi: 10.1177/2050313X241272670. eCollection 2024.
In extracorporeal circulation, inflammatory mediators are eliminated through inflammatory cytokine adsorption. By interacting with inflammatory cytokines and removing them from the bloodstream, the adsorber's adsorbent lowers levels of inflammatory mediators and the inflammatory response. We present the case of a 67-year-old Chinese man diagnosed with sepsis due to a bloodstream infection from a catheter. We promptly utilized a cytokine adsorption column in conjunction with continuous veno-venous hemodiafiltration (CVVHDF), resulting in a decrease in interleukin-6 levels and complete removal of bascteria from the bloodstream. A critical turning point in illness management is reached as the levels of inflammatory cytokines drop and the dosage of patients' vasoactive medications improves significantly. In hemodialysis patients with secondary septic shock in the context of catheter-associated bacteremia, the combination of CVVHDF with cytokine adsorption therapy in hemodialysis may be clinically useful and improve or accelerate the patient's improvement.
在体外循环中，炎症介质通过炎症细胞因子吸附被清除。吸附器的吸附剂与炎症细胞因子相互作用并将其从血液中去除，从而降低炎症介质水平和炎症反应。我们报告一例67岁中国男性病例，该患者因导管引起的血流感染被诊断为脓毒症。我们立即将细胞因子吸附柱与连续性静脉-静脉血液透析滤过（CVVHDF）联合使用，导致白细胞介素-6水平下降且血液中的细菌被完全清除。随着炎症细胞因子水平下降以及患者血管活性药物剂量显著改善，疾病管理达到关键转折点。在导管相关菌血症背景下继发感染性休克的血液透析患者中，CVVHDF与血液透析中的细胞因子吸附疗法联合应用可能具有临床实用性，并可改善或加速患者的康复。
