Haemoadsorption to remove inflammatory mediators in sepsis: past, present, and future
Abstract While a dysregulated immune response is at the center of the sepsis definition, standard care is still solely focussed on prompt administration of antimicrobial therapy, source control, resuscitation and organ supportive therapies. Extracorporeal blood purification therapies, such as haemoa...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2025-03-01
|
| Series: | Intensive Care Medicine Experimental |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40635-025-00740-0 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850057628515827712 |
|---|---|
| author | Nicole J. B. Waalders Matthijs Kox Peter Pickkers |
| author_facet | Nicole J. B. Waalders Matthijs Kox Peter Pickkers |
| author_sort | Nicole J. B. Waalders |
| collection | DOAJ |
| description | Abstract While a dysregulated immune response is at the center of the sepsis definition, standard care is still solely focussed on prompt administration of antimicrobial therapy, source control, resuscitation and organ supportive therapies. Extracorporeal blood purification therapies, such as haemoadsorption, have been proposed as a possible adjunctive therapy to standard care in sepsis. These adsorption devices aim to rebalance the dysregulated immune response by removal of excessive amounts of circulating inflammatory mediators, including cytokines and endotoxins. Thus far, the effects of haemoadsorption on clinical outcomes have been insufficiently studied and although its routine use is not justified based on the current evidence, multiple centers use these devices in patients with severe septic shock. This narrative review describes the most well-studied adsorption devices as well as a novel selective adsorption device called the ‘IL-6-Sieve’, including in vitro data showing its capturing potential. Finally, it addresses important considerations for future trials on haemoadsorption in septic patients. |
| format | Article |
| id | doaj-art-5db1c0d16bab4fa68ca33a1b5954e13b |
| institution | DOAJ |
| issn | 2197-425X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Intensive Care Medicine Experimental |
| spelling | doaj-art-5db1c0d16bab4fa68ca33a1b5954e13b2025-08-20T02:51:23ZengSpringerOpenIntensive Care Medicine Experimental2197-425X2025-03-0113111710.1186/s40635-025-00740-0Haemoadsorption to remove inflammatory mediators in sepsis: past, present, and futureNicole J. B. Waalders0Matthijs Kox1Peter Pickkers2Department of Intensive Care Medicine, Radboud university medical centerDepartment of Intensive Care Medicine, Radboud university medical centerDepartment of Intensive Care Medicine, Radboud university medical centerAbstract While a dysregulated immune response is at the center of the sepsis definition, standard care is still solely focussed on prompt administration of antimicrobial therapy, source control, resuscitation and organ supportive therapies. Extracorporeal blood purification therapies, such as haemoadsorption, have been proposed as a possible adjunctive therapy to standard care in sepsis. These adsorption devices aim to rebalance the dysregulated immune response by removal of excessive amounts of circulating inflammatory mediators, including cytokines and endotoxins. Thus far, the effects of haemoadsorption on clinical outcomes have been insufficiently studied and although its routine use is not justified based on the current evidence, multiple centers use these devices in patients with severe septic shock. This narrative review describes the most well-studied adsorption devices as well as a novel selective adsorption device called the ‘IL-6-Sieve’, including in vitro data showing its capturing potential. Finally, it addresses important considerations for future trials on haemoadsorption in septic patients.https://doi.org/10.1186/s40635-025-00740-0SepsisSeptic shockHemoadsorptionHemofiltrationBlood purificationCytokines |
| spellingShingle | Nicole J. B. Waalders Matthijs Kox Peter Pickkers Haemoadsorption to remove inflammatory mediators in sepsis: past, present, and future Intensive Care Medicine Experimental Sepsis Septic shock Hemoadsorption Hemofiltration Blood purification Cytokines |
| title | Haemoadsorption to remove inflammatory mediators in sepsis: past, present, and future |
| title_full | Haemoadsorption to remove inflammatory mediators in sepsis: past, present, and future |
| title_fullStr | Haemoadsorption to remove inflammatory mediators in sepsis: past, present, and future |
| title_full_unstemmed | Haemoadsorption to remove inflammatory mediators in sepsis: past, present, and future |
| title_short | Haemoadsorption to remove inflammatory mediators in sepsis: past, present, and future |
| title_sort | haemoadsorption to remove inflammatory mediators in sepsis past present and future |
| topic | Sepsis Septic shock Hemoadsorption Hemofiltration Blood purification Cytokines |
| url | https://doi.org/10.1186/s40635-025-00740-0 |
| work_keys_str_mv | AT nicolejbwaalders haemoadsorptiontoremoveinflammatorymediatorsinsepsispastpresentandfuture AT matthijskox haemoadsorptiontoremoveinflammatorymediatorsinsepsispastpresentandfuture AT peterpickkers haemoadsorptiontoremoveinflammatorymediatorsinsepsispastpresentandfuture |