Current Paediatrics
Volume 13, Issue 1 , Pages 18-22, February 2003

Evidence for the use of haemofiltration in sepsis

Royal Hospital for Sick Children, Yorkhill, Glasgow, G3 8SJ, UK

Article Outline

Abstract 

Continuous renal replacement therapy has for some years been suggested as part of the first-line treatment of multiple organ dysfunction syndrome following severe sepsis and related insults. We describe how this therapy works and discuss the evidence that exists for its use. Although most of the evidence of benefit to patients is anecdotal, sufficient has been published to suggest that these treatments may be beneficial and warrant further study in this area.

Keywords: haemofiltration, sepsis, multiple organ failure, renal replacement therapy

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

    REFERENCES
  1. Jones CH. Membranes for CRRT. Artif Organs. 1998;22:2–7
  2. Reeves JH, Butt WW. Blood filtration in children with severe sepsis: safe adjunctive therapy. Intens Care Med. 1995;21:500–504
  3. Journois D, Israel-Biet D, Pouard P. High-volume zero balanced hemofiltration to reduce delayed response to cardiopulmonary bypass in children. Anesthesiology. 1996;85:965–976
  4. Quellhorst EA. Ultrafiltration/hemofiltration practice. In:  Jacobs C,  Kjellstrand CM,  Koch KM,  Winchester JF editor. Replacement of Renal Function by Dialysis. Dordrecht: Kluwer Academic; 1996;p. 380–389
  5. Ronco C, Bellomo R, Homel P. Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure: a prospective randomised trial. Lancet. 2000;356:26–30
  6. Matson J, Lee P. Evolving concepts of therapy for sepsis and septic shock and the use of hyperpermeable membranes. Curr Opin Crit Care. 2000;6:431–436
  7. Schiffl H, Lang SM, Konig A, Strasser T, Haider MC, Held E. Biocompatible membranes in acute renal failure: prospective case controlled study. Lancet. 1994;344:570–572
  8. Tetta C, Cavaillon JM, Schulze M. Removal of cytokines and activated complement components in an experimental model of continuous plasma filtration coupled with sorbent adsorption. Nephrol Dial Transplant. 1998;13:1458–1464
  9. Aoki H, Masashi K, Tani T, Hanasawa K. Treatment of sepsis by extracorporeal elimination of endotoxin using polymyxin-B immobilized fibre. Am J Surg. 1994;167:412–417
  10. Mitzner S, Schneidewind J, Falkhagen D, Loth F, Klinkmann H. Extracorporeal endotoxin removal by immobilized polyethylene-imine. Artif Organs. 1993;17:775–781
  11. Abraham E, Matthay MA, Dinarello CA. Consensus conference definitions for sepsis, septic shock, acute lung injury, and acute respiratory distress syndrome: time for a re-evaluation. Crit Care Med. 2000;28:232–235
  12. Levin M, Quint P, Goldstein B. Recombinant bactericidal/permeability-increasing protein (rBPI21) as adjunctive treatment for children with severe meningococcal sepsis: a randomised trial. Lancet. 2000;356:961–967
  13. Grootendorst AF, van Bommel EF, van der Hoven B, van Leengoed LA, van Osta AL. High volume hemofiltration improves right ventricular function in endotoxin-induced shock in the pig. Intens Care Med. 1992;18:235–240
  14. Grootendorst AF, van Bommel EF, van Leengoed LA, van Zanten AR, Huipen HJ, Groeneveld AB. Infusion of ultrafiltrate from endotoxemic pigs depresses myocardial performance in normal pigs. J Crit Care. 1993;8:161–169
  15. Yekebas EF, Eisenberger CF, Ohnesorge H. Attenuation ;of sepsis-related immunoparalysis by continuous veno-venous hemofiltration in experimental porcine pancreatitis. Crit Care Med. 2001;29:1423–1430
  16. Hoffmann JN, Hartl WH, Deppisch R, Faist E, Jochum M, Inthorn D. Hemofiltration in human sepsis: evidence for elimination of immunomodulatory substances. Kidney Int. 1995;48:1563–1570
  17. Best C, Walsh J, Sinclair J, Beattie J. Early haemo-diafiltration in meningococcal septicaemia. Lancet. 1996;347:202
  18. Kumar A, Kanagasundaram NS, Collyns TA, Davison AM. Plasma exchange and haemodiafiltration in fulminant meningococcal sepsis. Nephrol Dial Transplant. 1998;13:484–487
  19. Pearson G, Khandelwal PC, Naqvi N. Early filtration and ;mortality in meningococcal septic shock?. Arch Dis Child. 2000;83:508–509
  20. Randolph AG, Lacroix L. Randomised clinical trials in paediatric critical care: rarely done but desperately needed. Pediatr Crit Care Med. 2002;3:102–106
  21. Cole L, Bellomo R, Journois D, Davenport P, Baldwin I, Tipping P. High-volume haemofiltration in human septic shock. Intens Care Med. 2001;27:978–986
  22. Honore PM, Jamez J, Wauthier M. Prospective evaluation of short-term, high-volume isovolemic hemofiltration on the hemodynamic course and outcome in patients with intractable circulatory failure resulting from septic shock. Crit Care Med. 2000;28:3581–3587
  23. Cole L, Bellomo R, Hart G. A phase II randomized, controlled trial of continuous hemofiltration in sepsis. Crit Care Med. 2002;30:100–106
  • f1 Correspondence to: CB. Tel./Fax: +44 (0) 141-201 0186; E-mail: crispin.best@yorkhill.scot.nhs.uk

PII: S0957-5839(03)90403-9

doi:10.1054/cupe.2003.0403

Current Paediatrics
Volume 13, Issue 1 , Pages 18-22, February 2003

Article Tools