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Annual Update in Intensive Care and Emergency Medicine 2016 pp 117–129Cite as

(Multiple) Organ Support Therapy Beyond AKI

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Part of the book series: Annual Update in Intensive Care and Emergency Medicine ((AUICEM))

Abstract

More than 30 years ago, extracorporeal treatment was used in the intensive care unit (ICU) for the first time in order to deliver hemodialysis. Due to improvements in medical and surgical standards of care and an increase in the average age of patients, clinicians are today facing a significant increase in patients’ severity of illness at ICU admission and the frequent occurrence of multiple organ failure (MOF) with the simultaneous dysfunction of two or more organs. Extracorporeal treatments to support different organs (kidneys, liver, lungs, heart, septic blood) are now common in the ICU. However, paralleling the evolution of continuous dialytic treatments over the last two decades, in recent years, multiple organ support therapy (MOST) has been delivered as a “Christmas-tree like” addition of one system on another (e.g., continuous renal replacement therapy [CRRT] on extracorporeal membrane oxygenation [ECMO] or molecular adsorbent recycling system [MARS] on CRRT). Current developments and the future of MOST foresee the application of dedicated and integrated multipurpose advanced platforms for the support of patients with MOF. This review will detail extracorporeal blood purification treatments that can be delivered for dysfunction of organs other than the kidneys.

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Author information

Authors and Affiliations

  1. Department of Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital, 00165, Rome, Italy

    Z. Ricci

  2. Department of Health Science, Section of Anesthesiology and Intensive Care, University of Florence, Florence, Italy

    S. Romagnoli

  3. Department of Anesthesia and Intensive Care, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

    S. Romagnoli

  4. Department of Nephrology, Dialysis and Transplantation, San Bortolo Hospital, Vicenza, Italy

    C. Ronco

  5. International Renal Research Institute, San Bortolo Hospital, Vicenza, Italy

    C. Ronco

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  1. Z. Ricci
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  2. S. Romagnoli
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  3. C. Ronco
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Correspondence to Z. Ricci .

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Editors and Affiliations

  1. Université libre de Bruxelles Dept. of Intensive Care, Erasme Hospital, Brussels, Belgium

    Jean-Louis Vincent

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Ricci, Z., Romagnoli, S., Ronco, C. (2016). (Multiple) Organ Support Therapy Beyond AKI. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2016. Annual Update in Intensive Care and Emergency Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-27349-5_11

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  • DOI: https://doi.org/10.1007/978-3-319-27349-5_11

  • Publisher Name: Springer, Cham

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