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Cytokine removal in human septic shock: Where are we and where are we going?

Honore, P.M., Hoste, E., Molnár, Z., Jacobs, R., Joannes-Boyau, O., Malbrain, M.L.N.G. and Forni, Lui (2019) Cytokine removal in human septic shock: Where are we and where are we going? Annals of Intensive Care, 9 (1), 56.

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Abstract

Although improving, the mortality from septic shock still remains high despite increased international awareness. As a consequence, much effort has focused on alternative treatment strategies in an effort to improve outcomes. The application of blood purification therapies to improve immune homeostasis has been suggested as one such method, but these approaches, such as high-volume continuous haemofiltration or cytokine and/or endotoxin removal, have enjoyed little success to date. More recently, the use of sorbent technologies has attracted much attention. These adsorbers are highly effective at removing inflammatory mediators, in particular, cytokines, from the bloodstream. This narrative review is the executive summary of meetings held throughout the 6th International Fluid Academy Days in Antwerp, Belgium (Nov 23–25, 2017), focusing on the current understanding regarding the use of such adsorbers in humans with septic shock. We followed a modified Delphi approach involving a combination of evidence appraisal together with expert opinion in order to achieve recommendations for practice and, importantly, future research.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Authors :
NameEmailORCID
Honore, P.M.
Hoste, E.
Molnár, Z.
Jacobs, R.
Joannes-Boyau, O.
Malbrain, M.L.N.G.
Forni, Luil.forni@surrey.ac.uk
Date : 14 May 2019
DOI : 10.1186/s13613-019-0530-y
Copyright Disclaimer : © The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creat iveco mmons .org/licen ses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Uncontrolled Keywords : Blood purification; Cytokines; Sepsis; Septic shock; Haemoperfusion; Cytosorb; Sorbents; Cartridges; Immune modulation; DAMPS; PAMPS
Depositing User : Diane Maxfield
Date Deposited : 28 Oct 2019 15:24
Last Modified : 28 Oct 2019 15:24
URI: http://epubs.surrey.ac.uk/id/eprint/852696

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