Spighi M, Faenza S, Fini M, Rocca M, Giardino R, Martinelli G
Institute of Anaesthesiology and Resuscitation, University of Bologna.
Boll Soc Ital Biol Sper. 1993 Nov;69(11):661-7.
The authors make a general review of the state of art in HP with particular reference to the history, the main field of application, and the development of specific and selective sorbents. In this text, attention is paid to the application in the immunological field comparing the therapeutical removal of toxins with different sorbents. Next, the authors describe their experimental study with hemoperfusion using coated anion exchange resins for the treatment of acute respiratory insufficiency, the correction of metabolic alkalosis in pyloric stenosis, the removal of a high dosage of antiblastic agent in conjunction with the study of heparin subtraction by coated resins and finally the development of a particular type of resin for phosphates removal in uremia. These different fields of research recognize the necessity to look for a selective exchange by hemoperfusion because the concept of the "magic filter" that removes everything is not scientifically acceptable. Some explanations are given for the behaviour of the strong anion exchange resins regarding simple or complex ions and the influence of the chemical composition of the matrix. In conclusion, the authors underline that selective removal by HP is actually underutilized considering its potency.
作者对血液灌流的技术现状进行了全面综述，特别提及了其历史、主要应用领域以及特异性和选择性吸附剂的发展。本文重点关注了血液灌流在免疫学领域的应用，比较了不同吸附剂对毒素的治疗性清除效果。接下来，作者描述了他们的实验研究，内容包括使用包膜阴离子交换树脂进行血液灌流治疗急性呼吸功能不全、纠正幽门狭窄中的代谢性碱中毒、结合包膜树脂对肝素减量的研究去除高剂量的抗胚细胞药物，以及最后开发一种用于治疗尿毒症时去除磷酸盐的特殊类型树脂。这些不同的研究领域认识到通过血液灌流寻找选择性交换的必要性，因为那种能清除一切的“神奇过滤器”概念在科学上是不可接受的。文中对强阴离子交换树脂针对简单或复杂离子的行为以及基质化学成分的影响给出了一些解释。总之，作者强调，考虑到血液灌流的效能，其选择性清除作用实际上未得到充分利用。
