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Molecular Medicine

, Volume 14, Issue 5–6, pp 257–263 | Cite as

Continuous Hemodiafiltration with PMMA Hemofilter in the Treatment of Patients with Septic Shock

  • Taka-aki Nakada
  • Shigeto Oda
  • Ken-ichi Matsuda
  • Tomohito Sadahiro
  • Masataka Nakamura
  • Ryuzo Abe
  • Hiroyuki Hirasawa
Research Article

Abstract

Septic shock is the most severe form of sepsis. It is widely accepted that cytokines play pivotal roles in the pathophysiology of septic shock. We reported previously that continuous hemodiafiltration (CHDF) using a polymethylmethacrylate (PMMA) membrane hemofilter removed various cytokines from blood continuously and efficiently, mainly by adsorption to membrane matrix of the hemofilter. Furthermore, in April 2000, we introduced to clinical practice a rapid assay system that determines blood levels of IL (interleukin)-6 in approximately 30 min. This enabled us to routinely measure blood IL-6 as an index of cytokine cascade activation in critically ill patients for real-time clinical monitoring of hypercytokinemia. The aim of the present cohort study was to evaluate the clinical efficacy of PMMA-CHDF in septic shock, a typical condition associated with hypercytokinemia. Forty-three patients with septic shock were assessed by monitoring of blood IL-6 level with a rapid assay system and immediate initiation of critical care including PMMA-CHDF for cytokine removal. Following initiation of PMMA-CHDF, early improvement of hemodynamics was noted, as well as an increase in urine output. PMMA-CHDF treatment improved both hypercytokinemia (assessed by measurement of blood IL-6 level) and dysoxia (assessed by measurement of blood lactate level). The present findings suggest that cytokine-oriented critical care using PMMA-CHDF might be an effective strategy for the treatment of septic shock.

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Copyright information

© Feinstein Institute for Medical Research 2008

Authors and Affiliations

  • Taka-aki Nakada
    • 1
  • Shigeto Oda
    • 1
  • Ken-ichi Matsuda
    • 2
  • Tomohito Sadahiro
    • 1
  • Masataka Nakamura
    • 1
  • Ryuzo Abe
    • 1
  • Hiroyuki Hirasawa
    • 1
  1. 1.Department of Emergency and Critical Care MedicineChiba University Graduate School of MedicineChiba City, ChibaJapan
  2. 2.Department of Emergency and Critical Care MedicineUniversity of Yamanashi HospitalYamanashiJapan

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