• Masataka Nakamura, Shigeto Oda, Tomohito Sadahiro, Yoh Hirayama, Eizo Watanabe, Yoshihisa Tateishi, Taka-aki Nakada, and Hiroyuki Hirasawa.
• Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan. masatakan@faculty.chiba-u.jp
• Contrib Nephrol. 2010 Jan 1;166:73-82.

AbstractIt has been reported that various types of blood purification intended for the removal of humoral mediators, such as cytokines, were performed in patients with severe sepsis/septic shock. While high-volume hemofiltration, hemofiltration using high cut-off membrane filters, and direct hemoperfusion with a polymyxin-B immobilized column are widely used in the treatment of severe sepsis/septic shock, we perform continuous hemodiafiltration using a polymethylmethacrylate membrane hemofilter (PMMA-CHDF), which shows an excellent cytokine-adsorbing capacity, for the treatment of severe sepsis/septic shock. In our previous study, it was found that PMMA-CHDF could efficiently remove various pro-inflammatory cytokines such as TNFalpha, IL-6 and IL-8 from the bloodstream, resulting in early recovery from septic shock. Furthermore, PMMA-CHDF could remove anti-inflammatory cytokines such as IL-10 from bloodstream, suggesting that it might improve immunoparalysis as well. These findings suggest that PMMA-CHDF is useful for the treatment of patients with severe sepsis/septic shock as a cytokine modulator.Copyright 2010 S. Karger AG, Basel.

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