血液灌流器治疗急性中毒患者的新进展
New Advances in the Treatment of Patients with Acute Poisoning with Hemoperfusion Devices
DOI: 10.12677/ACM.2023.1361457, PDF,   
作者: 苏浩鹏, 于朝霞*：新疆医科大学第一附属医院重症医学中心，新疆 乌鲁木齐
关键词: 血液灌流；急性中毒；毒素；Hemoperfusion； Acute Poisoning； Toxins
摘要: 血液净化技术用于清除体内毒素已有50多年的历史，其在治疗急性中毒方面起到了前所未有的重要作用。其中通过血液灌流，提供了治疗疾病及清除体内无法完全清除有毒物质的机会。随着血液灌流技术进步，血液灌流器的不断改进提高了清除药物和其他毒素的效果，并拓展了对中毒患者体外支持的作用。对临床医生而言，采用血液灌流技术治疗急性中毒时需考虑到可被体外清除毒素的特性(例如，分子量、分布体积和蛋白质的结合)、所选血液灌流器和可应对相应风险的手段。本文对近年来血液灌流技术治疗急性中毒研究进展作一综述，以期对今后提高治疗急性中毒患者的生存率有所帮助。
Abstract: Blood purification techniques have been used to remove toxins from the body for more than 50 years and have played an unprecedented and important role in the treatment of acute poisoning. Among other things, blood perfusion provides the opportunity to treat disease and remove toxic substances from the body that cannot be completely removed. With advances in hemoperfusion technology, continuous improvements in hemoperfusion devices have increased the effectiveness of removing drugs and other toxins and expanded the role of extracorporeal support for poisoned pa-tients. For clinicians, the use of hemoperfusion techniques for the treatment of acute poisoning re-quires consideration of the properties of the toxins that can be removed in vitro (e.g., molecular weight, volume of distribution, and protein binding), the hemoperfusion device selected, and the means available to address the corresponding risks. This article reviews recent advances in hemoperfusion techniques for the treatment of acute poisoning with the aim of improving the sur-vival rate of patients treated for acute poisoning in the future.
文章引用：苏浩鹏, 于朝霞. 血液灌流器治疗急性中毒患者的新进展[J]. 临床医学进展, 2023, 13(6): 10407-10412. https://doi.org/10.12677/ACM.2023.1361457

参考文献

[1] Foster, J.D. (2020) Extracorporeal Therapies in the Emergency Room and Intensive Care Unit. Veterinary Clinics of North America: Small Animal Practice, 50, 1215-1236. [Google Scholar] [CrossRef] [PubMed]
[2] Ghannoum, M., Hoffman, R.S., Gosselin, S., et al. (2018) Use of Extracorporeal Treatments in the Management of Poisonings. Kidney International, 94, 682-688. [Google Scholar] [CrossRef] [PubMed]
[3] Harm, S., Schildböck, C. and Hartmann, J. (2020) Cytokine Re-moval in Extracorporeal Blood Purification: An in Vitro Study. Blood Purification, 49, 33-43. [Google Scholar] [CrossRef] [PubMed]
[4] Copelli, S., Lorenzin, A. and Ronco, C. (2023) Chemical-Physical Mecha-nisms of Adsorption for Blood Purification. Contributions to Nephrology, 200, 1-9.
[5] Kaçar, C.K., Uzundere, O., Kandemir, D. and Yektaş, A. (2020) Efficacy of HA330 Hemoperfusion Adsorbent in Patients Followed in the Intensive Care Unit for Septic Shock and Acute Kidney Injury and Treated with Continuous Venovenous Hemodiafiltration as Re-nal Replacement Therapy. Blood Purification, 49, 448-456. [Google Scholar] [CrossRef] [PubMed]
[6] Ankawi, G., Fan, W., Pomarè Montin, D., et al. (2019) A New Series of Sorbent Devices for Multiple Clinical Purposes: Current Evidence and Future Directions. Blood Purification, 47, 94-100. [Google Scholar] [CrossRef] [PubMed]
[7] Li, S. and Liang, Y. (2023) Effects of Hemoperfusion First Aid Process Reengineering on Electrolyte Disturbance, Liver Function and Prognosis in Patients with Acute Poisoning. Biotechnology and Genetic Engineering Reviews. [Google Scholar] [CrossRef] [PubMed]
[8] Ronco, C. and Bellomo, R. (2022) Hemoperfusion: Tech-nical Aspects and State of the Art. Critical Care, 26, Article No. 135. [Google Scholar] [CrossRef] [PubMed]
[9] Shi, L., Yu, G., Li, Y., Zhao, L., Wen, Z., Tao, Y., Wang, W. and Jian, X. (2022) The Toxicokinetics of Acute Paraquat Poisoning in Specific Patients: A Case Series. Journal of In-ternational Medical Research, 50, Article ID: 3000605221122745. [Google Scholar] [CrossRef] [PubMed]
[10] Wolley, M., Jardine, M. and Hutchison, C.A. (2018) Exploring the Clinical Relevance of Providing Increased Removal of Large Middle Molecules. Clinical Journal of the American So-ciety of Nephrology, 13, 805-814. [Google Scholar] [CrossRef] 
[11] Pomarè Montin, D., Ankawi, G., Lorenzin, A., et al. (2018) Biocom-patibility and Cytotoxic Evaluation of New Sorbent Cartridges for Blood Hemoperfusion. Blood Purification, 46, 187-195. [Google Scholar] [CrossRef] [PubMed]
[12] Rommes, J.H., Sangster, B., Berrens, L., Borst, C. and van Heijst, A.N. (1986) Biocompatibility of Haemoperfusion. Archives of Toxicology, 58, 187-195. [Google Scholar] [CrossRef] 
[13] Jha, V.K. and Padmaprakash, K.V. (2018) Extracorporeal Treatment in the Management of Acute Poisoning: What an Intensivist Should Know? Indian Journal of Critical Care Medicine, 22, 862-869. [Google Scholar] [CrossRef] 
[14] Jansen, T., Hoegberg, L.C.G., Eriksen, T., et al. (2019) Ami-triptyline Accumulation in Tissues after Coated Activated Charcoal Hemoperfusion—A Randomized Controlled Animal Poisoning Model. Naunyn-Schmiedeberg’s Archives of Pharmacology, 392, 1285-1292. [Google Scholar] [CrossRef] [PubMed]
[15] Yeh, Y.-T., Chen, C.-K., Lin, C.-C., et al. (2020) Does Hemoperfusion Increase Survival in Acute Paraquat Poisoning? A Retrospective Multicenter Study. Toxics, 8, Article No. 84. [Google Scholar] [CrossRef] [PubMed]
[16] Liu, Y., Wang, Z.-K., Liu, C.-Z., Liu, Y.-Y., Li, Q., Wang, H., Cui, F., Zhang, D.-W. and Li, Z.-T. (2022) Supramolecular Organic Frameworks as Adsorbents for Efficient Removal of Ex-cess Bilirubin in Hemoperfusion. ACS Applied Materials & Interfaces, 14, 47397-47408. [Google Scholar] [CrossRef] [PubMed]
[17] Zhao, D., Wang, Y., Wang, Y., et al. (2022) Randomized Control Study on Hemoperfusion Combined with Hemodialysis versus Standard Hemodialysis: Effects on Mid-dle-Molecular-Weight Toxins and Uremic Pruritus. Blood Purification, 11, 1-11.
[18] King, J.D., Kern, M.H. and Jaar, B.G. (2019) Extracorporeal Removal of Poisons and Toxins. Clinical Journal of the American Society of Nephrology, 14, 1408-1415. [Google Scholar] [CrossRef] 
[19] Hahn, R.G. (2020) Understanding Volume Kinetics. Acta Anaesthesiologica Scandinavica, 64, 570-578. [Google Scholar] [CrossRef] [PubMed]
[20] Alves, R.N., Rambla-Alegre, M., Braga, A.C., et al. (2019) Bioaccessibility of Lipophilic and Hydrophilic Marine Biotoxins in Seafood: An in Vitro Digestion Approach. Food and Chemical Toxi-cology, 129, 153-161. [Google Scholar] [CrossRef] [PubMed]
[21] Rey, S., Kulabukhov, V.M., Popov, A., Nikitina, O., Berdnikov, G., Magomedov, M., Kim, T., Masolitin, S., Ignatenko, O., Krotenko, N., Marysheva, A., Chaus, N., Ohinko, L., Mendibaev, M., Chumachenko, A. and Pisarev, V. (2023) Hemoperfusion Using the LPS-Selective Mesoporous Poly-meric Adsorbent in Septic Shock: A Multicenter Randomized Clinical Trial. Shock, 59, 846-854. [Google Scholar] [CrossRef] 
[22] Florens, N., Yi, D., Juillard, L. and Soulage, C.O. (2018) Using Binding Competitors of Albumin to Promote the Removal of Protein-Bound Uremic Toxins in Hemodialysis: Hope or Pipe Dream? Biochimie, 144, 1-8. [Google Scholar] [CrossRef] [PubMed]
[23] Dargent, A., Pais de Barros, J.-P., Saheb, S., et al. (2020) LDLApheresis as an Alternate Method for Plasma LPS Purification in Healthy Volunteers and Dyslipidemic and Septic Patients. Journal of Lipid Research, 61, 1776-1783. [Google Scholar] [CrossRef] 
[24] Wen, Z., Li, X., Zhang, Y., Shi, J., Zhang, J., Zheng, Y., Lin, Y., Jian, T., Jian, X., Kan, B. and Luan, X. (2022) Comparing the Application of Three Thrombosis Risk Assessment Mod-els in Patients with Acute Poisoning: A Cross-Sectional Survey. Frontiers in Medicine, 9, Article 1072467. [Google Scholar] [CrossRef] [PubMed]
[25] Wang, G., Li, Z., Zhang, Y., Pan, Y. and Chen, L. (2021) Com-parison of Combined Hemodialysis and Hemoperfusion with Hemoperfusion Alone in 106 Patients with Diabetic Ke-toacidosis and Acute Renal Failure: A Retrospective Study from a Single Center in China. Medical Science Monitor, 27, e922753. [Google Scholar] [CrossRef] 
[26] Ghannoum, M., Lavergne, V., Gosselin, S., et al. (2016) Practice Trends in the Use of Extracorporeal Treatments for Poisoning in Four Countries. Seminars in Dialysis, 29, 71-80. [Google Scholar] [CrossRef] [PubMed]
[27] Ronco, C., Chawla, L., Husain-Syed, F. and Kellum, J.A. (2023) Ra-tionale for Sequential Extracorporeal Therapy (SET) in Sepsis. Critical Care, 27, Article No. 50. [Google Scholar] [CrossRef] [PubMed]
[28] Yu, Y. and Ou, L. (2023) The Development of Immunosorbents for the Treatment of Systemic Lupus Erythematosus via Hemoperfusion. Frontiers in Medicine, 9, Article 1035150. [Google Scholar] [CrossRef] [PubMed]
[29] Fick, M.E., Messenger, K.M. and Vigani, A. (2020) Efficacy of a Single Session in-Series Hemoperfusion and Hemodialysis in the Management of Carprofen Overdose in Two Dogs. Journal of Veterinary Emergency and Critical Care, 30, 226-231. [Google Scholar] [CrossRef] [PubMed]
[30] Li, J., Li, H., Deng, W., Meng, L., Gong, W. and Yao, H. (2022) The Effect of Combination Use of Hemodialysis and Hemoperfusion on Microinflammation in Elderly Patients with Maintenance Hemodialysis. Blood Purification, 51, 739-746. [Google Scholar] [CrossRef] [PubMed]

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