TYPE OF THERAPY

MECHANISM

OBJECTIVE

HEMOPERFUSION

The passage of the blood through a column containing adsorbent particles (actived charcoal or resin).

Strategy to improve the evolution of septic patients, reducing the systemic expression of pro-inflammatory factors and anti-inflammatory mediators and restoring the balance of the immune system.

PLASMAPHERESIS

Separation of the blood components and exchanged for a replacement fluid, usually fresh frozen plasma (PFC) or albumin, depending on the disease, the general state of coagulation and the immune system.

The basic premise of therapeutic apheresis focuses on eliminating or reducing the levels of certain pathological substances in the plasma, which can be autoantibodies, immune complexes, cryoglobulins, light myeloma chains, endotoxins, cholesterol-containing lipoproteins or other substances.

LIVER DIALYSIS WITH ALBUMIN /CONTINUOUS ADSORPTIVE PLASMAFILTRATION

Eliminate albumin-bound toxins that accumulate in the context of liver failure.

Actually exist the molecular recirculation adsorbent system (MARS), the one-step albumin dialysis system (SPAD) and a fractionated plasma separation and adsorption system - FPSA (Prometheus).

There are no precise indications on the opportune use. In the absence of alternative options to support this vital organ, it is difficult to restrict the cautious use of these safe artificial liver devices, as “salvage therapy” for patients suffering from acute liver failure. There are no precise indications on the opportune use.

VENO-VENOUS ECMO (VV) – VENO-ARTERIAL (VA)

Extracorporeal membrane oxygenation provide temporary extracorporeal respiratory support through the use of artificial oxygenation membranes in the case of pulmonary insufficiency that does not respond to treatment.

Improve cardiovascular and respiratory function with the extracorporeal oxygenation.

In patients with respiratory insufficiency the VV-ECMO bypass is the most used. The use of VA-ECMO is frequently used in patients with refractory cardiogenic shock and cardiac arrest.

CARBON DIOXIDE REMOVAL (ECCO2)

Extract CO₂ from venous blood, through a membrane similar to those of ECMO devices, its difference is based on the use of much lower blood flows and therefore smaller arterial or venous cannulas.

The utility is for patients with severe ARDS who had an important hypercapnia from a protective ventilation strategy.