The Japanese Journal of Clinical Dialysis Vol.15 No.10(3)

Theme Multiple Organ Failure and Blood Purification Therapy
Title Removal of cytokines and endotoxin
Publish Date 1999/09
Author Hideki Kawanishi Akane Foundation Tsuchiya General Hospital
[ Summary ] Diffusion, convection, adsorption and generation of cytokines should be considered during the removal of inflammatory cytokines by blood purification methods. Continuous hemodiafiltration (CHDF) should be thought of as a basic clinical method. For effective removal, selection of proper membrane properties and filtration conditions is necessary. With that in mind, the techniques developed for HPM dialysis should be applied to the intensive care field. On the other hand, it may be possible to remove endotoxins in the blood stream because of the development of PMX (Toraymyxin). Indications of PMX, endotoximia and septic shock should be met first. It may become inportant for clinical evaluations to include some effectively treated cases, which have low endotoxin levels.
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