Extracorporeal blood therapy in @entity295 and XXXX : the "purifying dream".

@entity1 @entity295 @entity649 @entity8450 @entity264 @entity647
OBJECTIVE: To discuss the rationale, hypothesis, modality of extracorporeal blood purification (EBP) techniques for the critically ill animal models or @entity1 , and to summarize the experimental and clinical studies with inconsistent data which explored the EBP's efficacy in the areas of critical care medicine. DATA SOURCES: Articles referred in this review were collected from the database of PubMed published in English up to June 2014. STUDY SELECTION: We had done a literature search by using the term "( @entity295 OR @entity647 OR @entity649 ) AND (extracorporeal blood purification OR hemofiltration OR hemoperfusion OR @entity8450 OR plasmapheresis OR adsorpiton)". Related original or review articles were included and carefully analyzed. RESULTS: Acute cellular and humoral immune disturbances occur in both @entity295 and @entity649 ( @entity649 ). Treatments aimed at targeting one single pro-/anti-inflammatory mediator have largely failed with no proven clinical benefits. Such failure shifts the therapeutic rationale to the nonspecific, broad-spectrum methods for modulating the over-activated inflammatory and anti-inflammatory response. Therefore, EBP techniques have become the potential weapons with high promise for removing the circulating pro-/anti-inflammatory mediators and promoting immune reconstitution. Over the years, multiple extracorporeal techniques for the critically ill animal models or @entity1 have been developed, including hemofiltration (HF), high-volume hemofiltration (HVHF), high-cutoff hemofiltration ( @entity264 -HF), hemo-perfusion or -adsorption (HP/HA), coupled plasma filtration adsorption (CPFA), and @entity8450 ( @entity8450 ). These previous studies showed that EBP therapy was feasible and safe for the critically ill animal models or @entity1 . However, data on their efficacy (especially on the clinical benefits, such as mortality) were inconsistent. CONCLUSIONS: It is not now to conclude that EBP intervention can purify septic or @entity649 @entity1 with high clinical efficacy from current experimental and clinical practice. Prospective, randomized controlled, and well-designed clinical or experimental studies and most suitable EBP modalities should be further developed.
