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Pumpless Extracorporeal Hemadsorption Technique (pEHAT): A Proof-of-Concept Animal Study

Background: Extracorporeal hemadsorption eliminates proinflammatory mediators in critically ill patients with hyperinflammation. The use of a pumpless extracorporeal hemadsorption technique allows its early usage prior to organ failure and the need for an additional medical device. In our animal mod...

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Autores principales: Fiedler, Mascha O., Muellenbach, Ralf M., Rolfes, Caroline, Lotz, Christopher, Nickel, Felix, Müller-Stich, Beat P., Supady, Alexander, Lepper, Philipp M., Weigand, Markus A., Meybohm, Patrick, Kalenka, Armin, Reyher, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9692831/
https://www.ncbi.nlm.nih.gov/pubmed/36431292
http://dx.doi.org/10.3390/jcm11226815
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author Fiedler, Mascha O.
Muellenbach, Ralf M.
Rolfes, Caroline
Lotz, Christopher
Nickel, Felix
Müller-Stich, Beat P.
Supady, Alexander
Lepper, Philipp M.
Weigand, Markus A.
Meybohm, Patrick
Kalenka, Armin
Reyher, Christian
author_facet Fiedler, Mascha O.
Muellenbach, Ralf M.
Rolfes, Caroline
Lotz, Christopher
Nickel, Felix
Müller-Stich, Beat P.
Supady, Alexander
Lepper, Philipp M.
Weigand, Markus A.
Meybohm, Patrick
Kalenka, Armin
Reyher, Christian
author_sort Fiedler, Mascha O.
collection PubMed
description Background: Extracorporeal hemadsorption eliminates proinflammatory mediators in critically ill patients with hyperinflammation. The use of a pumpless extracorporeal hemadsorption technique allows its early usage prior to organ failure and the need for an additional medical device. In our animal model, we investigated the feasibility of pumpless extracorporeal hemadsorption over a wide range of mean arterial pressures (MAP). Methods: An arteriovenous shunt between the femoral artery and femoral vein was established in eight pigs. The hemadsorption devices were inserted into the shunt circulation; four pigs received CytoSorb(®) and four Oxiris(®) hemadsorbers. Extracorporeal blood flow was measured in a range between mean arterial pressures of 45–85 mmHg. Mean arterial pressures were preset using intravenous infusions of noradrenaline, urapidil, or increased sedatives. Results: Extracorporeal blood flows remained well above the minimum flows recommended by the manufacturers throughout all MAP steps for both devices. Linear regression resulted in CytoSorb(®) blood flow [mL/min] = 4.226 × MAP [mmHg] − 3.496 (R-square 0.8133) and Oxiris(®) blood flow [mL/min] = 3.267 × MAP [mmHg] + 57.63 (R-square 0.8708), respectively. Conclusion: Arteriovenous pumpless extracorporeal hemadsorption resulted in sufficient blood flows through both the CytoSorb(®) and Oxiris(®) devices over a wide range of mean arterial blood pressures and is likely an intriguing therapeutic option in the early phase of septic shock or hyperinflammatory syndromes.
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spelling pubmed-96928312022-11-26 Pumpless Extracorporeal Hemadsorption Technique (pEHAT): A Proof-of-Concept Animal Study Fiedler, Mascha O. Muellenbach, Ralf M. Rolfes, Caroline Lotz, Christopher Nickel, Felix Müller-Stich, Beat P. Supady, Alexander Lepper, Philipp M. Weigand, Markus A. Meybohm, Patrick Kalenka, Armin Reyher, Christian J Clin Med Article Background: Extracorporeal hemadsorption eliminates proinflammatory mediators in critically ill patients with hyperinflammation. The use of a pumpless extracorporeal hemadsorption technique allows its early usage prior to organ failure and the need for an additional medical device. In our animal model, we investigated the feasibility of pumpless extracorporeal hemadsorption over a wide range of mean arterial pressures (MAP). Methods: An arteriovenous shunt between the femoral artery and femoral vein was established in eight pigs. The hemadsorption devices were inserted into the shunt circulation; four pigs received CytoSorb(®) and four Oxiris(®) hemadsorbers. Extracorporeal blood flow was measured in a range between mean arterial pressures of 45–85 mmHg. Mean arterial pressures were preset using intravenous infusions of noradrenaline, urapidil, or increased sedatives. Results: Extracorporeal blood flows remained well above the minimum flows recommended by the manufacturers throughout all MAP steps for both devices. Linear regression resulted in CytoSorb(®) blood flow [mL/min] = 4.226 × MAP [mmHg] − 3.496 (R-square 0.8133) and Oxiris(®) blood flow [mL/min] = 3.267 × MAP [mmHg] + 57.63 (R-square 0.8708), respectively. Conclusion: Arteriovenous pumpless extracorporeal hemadsorption resulted in sufficient blood flows through both the CytoSorb(®) and Oxiris(®) devices over a wide range of mean arterial blood pressures and is likely an intriguing therapeutic option in the early phase of septic shock or hyperinflammatory syndromes. MDPI 2022-11-18 /pmc/articles/PMC9692831/ /pubmed/36431292 http://dx.doi.org/10.3390/jcm11226815 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Fiedler, Mascha O.
Muellenbach, Ralf M.
Rolfes, Caroline
Lotz, Christopher
Nickel, Felix
Müller-Stich, Beat P.
Supady, Alexander
Lepper, Philipp M.
Weigand, Markus A.
Meybohm, Patrick
Kalenka, Armin
Reyher, Christian
Pumpless Extracorporeal Hemadsorption Technique (pEHAT): A Proof-of-Concept Animal Study
title Pumpless Extracorporeal Hemadsorption Technique (pEHAT): A Proof-of-Concept Animal Study
title_full Pumpless Extracorporeal Hemadsorption Technique (pEHAT): A Proof-of-Concept Animal Study
title_fullStr Pumpless Extracorporeal Hemadsorption Technique (pEHAT): A Proof-of-Concept Animal Study
title_full_unstemmed Pumpless Extracorporeal Hemadsorption Technique (pEHAT): A Proof-of-Concept Animal Study
title_short Pumpless Extracorporeal Hemadsorption Technique (pEHAT): A Proof-of-Concept Animal Study
title_sort pumpless extracorporeal hemadsorption technique (pehat): a proof-of-concept animal study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9692831/
https://www.ncbi.nlm.nih.gov/pubmed/36431292
http://dx.doi.org/10.3390/jcm11226815
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