caa a22 4500 477035930 CHVBK 20180405111305.0 cr unu---uuuuu 170330e19960501xx s 000 0 eng 10.1007/s002689900076 doi (NATIONALLICENCE)springer-10.1007/s002689900076 Blood Purification for Prevention and Treatment of Multiple Organ Failure [Elektronische Daten] [Hiroyuki Hirasawa, Takao Sugai, Yoshio Ohtake, Shigetoshi Oda, Kenichi Matsuda, Nobuya Kitamura] Abstract. Blood purification has been applied conventionally as an artificial kidney or artificial liver in the management of patients with multiple organ failure (MOF), and most blood purifications have been performed intermittently. Recent advances in medical engineering made it possible to perform such blood purifications continuously (i.e., 24 hours a day, 7 days a week if necessary) even in critically ill patients. This modality is referred to as continuous renal replacement therapy (CRRT) or continuous blood purification (CBP). Among many kinds of CBP, continuous hemodiafiltration (CHDF) is most useful for management of MOF, as it can be performed without serious or hazardous side effects, and improvement can be expected with it. Recently, CHDF and polymyxin B immobilized endotoxin adsorption columns were used for the prevention or treatment of MOF, with the expectation that such therapy can be effective as a countermeasure against the pathophysiologic causes of MOF. Our data and that of others clearly indicate that continuous blood purification, such as with CHDF and endotoxin adsorption, can remove or decrease the blood levels of humoral mediators, including proinflammatory cytokines, and can improve tissue oxygenation, especially oxygen consumption (VO2) among critically ill patients including those with MOF. Blood purification is also useful in the careful management of fluid, electrolytes, and acid-base balance and for the removal of metabolic wastes. Blood purification is now considered to be one of the basic therapeutic tools of critical care, equal to nutritional support with total parenteral nutrition and respiratory support without a ventilator.: 1996 by the Société Internationale de Chir, ugie Hirasawa Hiroyuki Department of Emergency and Critical Care Medicine, Chiba University School of Medicine, 1-8-1 Inohana, Chiba 260, Japan, JP aut Sugai Takao Department of Emergency and Critical Care Medicine, Chiba University School of Medicine, 1-8-1 Inohana, Chiba 260, Japan, JP aut Ohtake Yoshio Department of Emergency and Critical Care Medicine, Chiba University School of Medicine, 1-8-1 Inohana, Chiba 260, Japan, JP aut Oda Shigetoshi Department of Emergency and Critical Care Medicine, Chiba University School of Medicine, 1-8-1 Inohana, Chiba 260, Japan, JP aut Matsuda Kenichi Department of Emergency and Critical Care Medicine, Chiba University School of Medicine, 1-8-1 Inohana, Chiba 260, Japan, JP aut Kitamura Nobuya Department of Emergency and Critical Care Medicine, Chiba University School of Medicine, 1-8-1 Inohana, Chiba 260, Japan, JP aut https://doi.org/10.1007/s002689900076 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002689900076 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hirasawa Hiroyuki Department of Emergency and Critical Care Medicine, Chiba University School of Medicine, 1-8-1 Inohana, Chiba 260, Japan, JP aut NATIONALLICENCE 700 1- Sugai Takao Department of Emergency and Critical Care Medicine, Chiba University School of Medicine, 1-8-1 Inohana, Chiba 260, Japan, JP aut NATIONALLICENCE 700 1- Ohtake Yoshio Department of Emergency and Critical Care Medicine, Chiba University School of Medicine, 1-8-1 Inohana, Chiba 260, Japan, JP aut NATIONALLICENCE 700 1- Oda Shigetoshi Department of Emergency and Critical Care Medicine, Chiba University School of Medicine, 1-8-1 Inohana, Chiba 260, Japan, JP aut NATIONALLICENCE 700 1- Matsuda Kenichi Department of Emergency and Critical Care Medicine, Chiba University School of Medicine, 1-8-1 Inohana, Chiba 260, Japan, JP aut NATIONALLICENCE 700 1- Kitamura Nobuya Department of Emergency and Critical Care Medicine, Chiba University School of Medicine, 1-8-1 Inohana, Chiba 260, Japan, JP aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer