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Title: Techniques of extracorporeal cytokine removal: a systematic review of the literature.
Austin Authors: Atan, Rafidah;Crosbie, David;Bellomo, Rinaldo 
Affiliation: Department of Intensive Care, Austin Hospital, Heidelberg, Victoria, Australia
Issue Date: 13-Jan-2012
Publication information: Blood Purification 2012; 33(1-3): 88-100
Abstract: 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.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.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.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.
Gov't Doc #: 22248671
DOI: 10.1159/000333845
Journal: Blood Purification
Type: Journal Article
Subjects: Adsorption
Cytokines.blood.isolation & purification
Plasma Exchange.instrumentation.methods
Renal Replacement Therapy.instrumentation.methods
Appears in Collections:Journal articles

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