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Title: Hemoperfusion: technical aspects and state of the art.
Austin Authors: Ronco, Claudio;Bellomo, Rinaldo 
Affiliation: Data Analytics Research and Evaluation (DARE) Centre
Intensive Care..
Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Australia..
Department of Critical Care, University of Melbourne, Melbourne, Australia..
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia..
Department of Medicine, University of Padova, Padua, Italy..
International Renal Research Institute of Vicenza (IRRV), Vicenza, Italy..
Department of Nephrology, San Bortolo Hospital, Vicenza, Italy..
Issue Date: 12-May-2022
Date: 2022
Publication information: Critical care 2022; 26(1): 135
Abstract: Blood purification through the removal of plasma solutes by adsorption to beads of charcoal or resins contained in a cartridge (hemoperfusion) has a long and imperfect history. Developments in production and coating technology, however, have recently increased the biocompatibility of sorbents and have spurred renewed interest in hemoperfusion. We performed a narrative assessment of the literature with focus on the technology, characteristics, and principles of hemoperfusion. We assessed publications in ex vivo, animal, and human studies. We synthesized such literature in a technical and state-of-the-art summary. Early hemoperfusion studies were hampered by bioincompatibility. Recent technology, however, has improved its safety. Hemoperfusion has been used with positive effects in chronic dialysis and chronic liver disease. It has also demonstrated extraction of a variety of toxins and drugs during episodes of overdose. Trials with endotoxin binding polymyxin B have shown mixed results in septic shock and are under active investigation. The role of non-selective hemoperfusion in sepsis or inflammation remains. Although new technologies have made sorbents more biocompatible, the research agenda in the field remains vast. New sorbents markedly differ from those used in the past because of greater biocompatibility and safety. Initial studies of novel sorbent-based hemoperfusion show some promise in specific chronic conditions and some acute states. Systematic studies of novel sorbent-based hemoperfusion are now both necessary and justified.
DOI: 10.1186/s13054-022-04009-w
ORCID: 0000-0003-1520-9387
Journal: Critical care (London, England)
PubMed URL: 35549999
Type: Journal Article
Appears in Collections:Journal articles

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