Severe sepsis and septic shock often result in multiple organ dysfunction syndromes because of dysregulated host immune response and over production of cytokines.
Often the resultant cytokine storm causes difficulty in achieving hemodynamic stability & preventing multiple organ dysfunctions with the standard intensive care treatment alone.
Extracorporeal therapy can be a promising supportive treatment to remove excess inflammatory mediators, lower inflammatory cascade reaction and achieve hemodynamic stability.
CVVH is shown to partly improve clinical symptoms and signs of patients, and plays a beneficial role in treatment of MODS, but the clearance of inflammatory cytokines is limited because of material and the diameter of the membrane. CVVH is not able to remove larger molecules exceeding the molecular weight cutoff of CVVH and some inflammatory mediators with lipid solubility, high protein binding capacity, but new resin adsorbents like HA 330 can resolve this problem.
HA 330 resin cartridge is an extracorporeal hemoperfusion device that uses neutral macroporous resin, and it has been proven to specifically adsorb different mediators such as cytokines. Regarding specific pore size, the HA330 resin cartridge has the specific adsorption of medium and large sized inflammatory cytokines such as the interleukin family (IL-1, IL-6, IL-8) and TNF-α.
Blood hemoperfusion with HA 330 can clean larger molecules exceeding the molecular weight cutoff of CVVH. HA 330 showed a significant improvement in hemodynamic parameters, such as the reduction in vasopressor dose, improvement in Cardiac Index, Mean Arterial Pressure, and Systemic Vascular Resistance Index. HA 330 is shown to increase T-lymphocytes subpopulations CD3+, CD4+, CD8+, CD4+/CD8+, improve immune function disorder, and helpful to the reconstruction of the immune system. Thereby supportive treatment with HA 330 improves organ function and ICU outcome.
And blood hemoperfusion with HA 330 either alone or combined CVVH (HP+CVVH) has a higher ability of mediator clearance and can improve clinical outcomes.
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