Cytokine-adsorbing hemofilter：バクスターセプザイリス（AN69ST膜hemofilter）

Size: px

Start display at page:

Download "Cytokine-adsorbing hemofilter：バクスターセプザイリス（AN69ST膜hemofilter）"

せいごろうのじま
5 years ago
Views:

Cytokine-adsorbing hemofilter AN69ST hemofilter Acute Care Kazuhiro MORIYAMA, Noriko ONOZUKA, Hidehito TSUNASHIMA 1. はじめに 1) CRRT AN69ST 2) sepxiris 2014 7 1 2 AN69ST 2.

1 Cytokine-adsorbing hemofilter AN69ST hemofilter Acute Care Kazuhiro MORIYAMA, Noriko ONOZUKA, Hidehito TSUNASHIMA 1. はじめに 1) CRRT AN69ST 2) sepxiris AN69ST 2. AN69 膜の開発経緯著者連絡先 Acute Care kazuhiro_moriyama@baxter.com AN69 AN69 図 1 AN69 3) 5) AN69 PAN PAN 6) 3. AN69ST 膜の開発 AN69ST AN ),7),9) 図 2 4. AN69ST 膜の構造ハイドロゲル構造 AN69 AN69ST 70 accessibility 2) 233

AN69ST hemofilter TMP PMMA 12) AN69ST 13) 図 3 14) RENAL study AN69

2 図 1 AN69 図 2 AN69ST 図 3 high mobility group box 1 HMGB1 10),11) HMGB1 CL PMMA hemofilter 25 ml/min AN69ST hemofilter 60 ml/min PMMA hemofilter TMP AN69ST hemofilter TMP PMMA 12) AN69ST 13) 図 3 14) RENAL study AN69 hemofilter 50 2,700 ml/h 24 15) 5. AN69ST 膜の特性イオン結合によるサイトカイン吸着 16) 5 10 PMMA 234

3 図 3 図 4 AN69 AN69ST 図 4 7) 6. 血液濾過によるサイトカインの除去濾過の限界と吸着の優位性 kd CL 14),17) AN69ST HMGB1 CL 60 ml/min 17 ml/min 10),11) CL 14) 1),14),18) 19),20) 235

4 表 ),21) oxiris NCT セプザイリスの治験成績と保険適用 Surviving Sepsis Campaign guidelines SSCG ) 23) CRRT non-renal indication 18),23),24) 24) 4 mmol/l APACHE 32.7 APACHE ) SSCG 26) 25) 6 表おわりに AN69ST 利益相反の開示文献 1) Cytokine Adsorbing Hemofilter-CHDF -up-to-date : , ) Thomas M, Moriyama K, Ledebo I: AN69: Evolution of the world s first high permeability membrane. Contrib Nephrol 173: , ) Peng Y, Yuan Z, Li H: Removal of inflammatory cytokines and endotoxin by veno-venous continuous renal replacement therapy for burned patients with sepsis. Burns 31: 623-8, ) Dahaba AA, Elawady GA, Rehak PH, et al: Procalcitonin and proinflammatory cytokine clearance during continuous venovenous haemofiltration in septic patients. Anaesth Intensive Care 30: , ) Peng Z, Pai P, Hong-Bao L, et al: The impacts of continuous veno-venous hemofiltration on plasma cytokines and monocyte human leukocyte antigen-dr expression in septic patients. Cytokine 50: , ) PAN polyacrylonitrile 2012, ) Chanard J, Lavaud S, Paris B, et al: Assessment of heparin binding to the AN69 ST hemodialysis membrane: I. preclinical studies. ASAIO J 51: 342-7, ) Désormeaux A, Moreau ME, Lepage Y, et al: The effect of electronegativity and angiotensin-converting enzyme inhibition on the kinin-forming capacity of polyacrylonitrile dialysis membranes. Biomaterials 29: , ) Lavaud S, Canivet E, Wuillai A, et al: Optimal anticoagulation strategy in haemodialysis with heparin-coated 236

5 polyacrylonitrile membrane. Nephrol Dial Transplant 18: , ) high mobility group box 1 HMGB1 2: , ) Yumoto M, Nishida O, Moriyama K, et al: In vitro evaluation of high mobility group box 1 protein removal with various membranes for continuous hemofiltration. Ther Apher Dial 15: , ) Yamashita AC, Tomisawa N: Importance of membrane materials for blood purification devices in critical care. Transfus Apher Sci 40: 23-31, ) HMGB1 31: , ) alarmin high mobility group box 1 protein HMGB1 2: 52-60, ) RENAL Replacement Therapy Study Investigators, Bellomo R, Cass A, et al: Intensity of continuous renal-replacement therapy in critically ill patients. N Engl J Med 361: , ) Rimmelé T, Kellum JA: High-volume hemofiltration in the intensive care unit: a blood purification therapy. Anesthesiology 116: , ) Moriyama K, Soejima Y: Continuous hemodiafiltration using PMMA membrane: clinical efficacy and its mechanisms. Contrib Nephrol 125: , ) 17: , ) 37: 56-61, ) Matsuda K, Moriguchi T, Harii N, et al: Comparison of efficacy between continuous hemodiafiltration with a PMMA membrane hemofilter and a PAN membrane hemofilter in the treatment of a patient with septic acute renal failure. Transfus Apher Sci 40: 49-53, ) Joannes-Boyau O, Honoré PM, Perez P, et al: High-volume versus standard-volume haemofiltration for septic shock patients with acute kidney injury (IVOIRE study): a multicentre randomized controlled trial. Intensive Care Med 39: , ) Dellinger RP, Levy MM, Rhodes A, et al: Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: Crit Care Med 41: , ) Sepsis Registry 20: , ) / CHDF 22: , ) Hirasawa H, Oda S, Nakamura M, et al: Continuous hemodiafiltration with a cytokine-adsorbing hemofilter for sepsis. Blood Purif 34: , ) 34: ,

164 SDD & SOD SDD E100 mg 80 mg B500 mg 2 E 2 B 48 /59 81 SDD SOD 10 /63 16 RCT RCT 1992 Gastinne 15 ICU 445 SDD E100 mg 80 mg B 10

164 SDD & SOD SDD E100 mg 80 mg B500 mg 2 E 2 B 48 /59 81 SDD SOD 10 /63 16 RCT RCT 1992 Gastinne 15 ICU 445 SDD E100 mg 80 mg B 10 163 特集 SDD & SOD SDD(Selective digestive decontamination),sod(selective oropharynx decontamination), 腸内細菌叢, 耐性菌 Ⅰ はじめに SDD Selective digestive decontamination SOD Selective oropharynx decontamination

Cytokine-adsorbing hemofilter：バクスター セプザイリス（AN69ST膜hemofilter）

Cytokine-adsorbing hemofilter：バクスターセプザイリス（AN69ST膜hemofilter）