sirs and sepsis in critical care medicine · 7. kuntsevich v. i. et allal. artif cells blood...
TRANSCRIPT
• Controlthesystemicinflammation• Modulatetheimmuneresponse• Improvehemodynamicsandfluidbalance• Preventandlimitorganfailure
SIRS and Sepsisin Critical Care Medicine
Your CytoSorb therapy goals:
REGAIN CONTROL
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Post surgical
Pancreatitis
Trauma / Burns
Others
(AccordingtoBoneRCetal.,Chest1992)
Bacterial
Viral
Fungal
Others
• Improvementofhemodynamicstability(1)
• Reductionofcatecholamineneed
• Positiveimpactoncapillaryleaksyndromeandfluidbalance(2)
• Preventionandlimitationofinflammationinducedorganfailure(3,4)
Stabilization of hemodynamics and organ functions
• Effectivereductionofexcessivecytokinelevels(1,2)
• Decreaseddenovosynthesisofinflammatorymediators(3,5)
• Controlledattenuationoftheovershootingimmuneresponse(2,6)
• Re-targetingofthecellularimmunedefensetothefocusofinfection(2,6)
Modulation of the immune response
• Safeandeasytousewholebloodperfusion
• Easytocombinewithroutinerenalreplacementtherapieswithinminutes
• Stand-alonehemoperfusionsetuppossible
• Quickandsustainedreductionofexcessivecytokinelevelsandremovalofmyoglobin,bilirubinandfreehemoglobin(1,7)
• Useofstandardanticoagulation(heparinorcitrate)
• Excellenthemo-andbiocompatibility(fulfillsISO10993)
Unique extracorporeal therapy
Literature:
1. PengZYetal.CritCareMed.2008May;36(5):1573-72. PengZYetal.CritCare.2014Jul3;18(4):R1413. PengZYetal.KidneyInt.2012Feb;81(4):363-94. MikhovaKMetal.JThoracCardiovascSurg.2013Jan;145(1):215-24
5. KellumJAetal.CritCareMed.2004Mar;32(3):801-56. NamasRAetal.MolMed.2012Dec20;18:1366-747. KuntsevichV.I.etal.ArtifCellsBloodSubstitBiotechnol2009,37(1):45-78. Skrupkyetal.Anesthesiology2011;115(6):1349-1362
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Intelligent polymer technology
Types of immunologic response in sepsis (8)
Late Deaths
hypoimmunestatus
normalimmunestatus
hyperimmunestatus
Early Deaths
Time(Days)
recove
ry2 4 6 8
A)healthyindividualwithmeningococcemiaB)elderlypatientwithmalnutritionanddiverticulitisC)diabeticwithchronicrenalfailureandpneumonia
A
B
C
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