Bioartificial Therapy of Sepsis: Changes of Norepinephrine-Dosage in Patients and Influence on Dynamic and Cell Based Liver Tests during Extracorporeal Treatments
| Autor: | Georg Richter, Steffen Mitzner, Martin Sauer, Stephanie Koch, Annette Pertschy, Thomas Mencke, Maren Thomsen, Cristof Haubner, Jörg Henschel, Johannes Ehler, Thomas Wild, Gabriele Nöldge-Schomburg, Fanny Doß, Sandra Doß, Jens Altrichter |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Extracorporeal Circulation lcsh:Medicine Cell Count 030204 cardiovascular system & hematology Cohort Studies Norepinephrine 0302 clinical medicine Liver Function Tests Aged 80 and over medicine.diagnostic_test Liver cell General Medicine Hep G2 Cells Middle Aged medicine.anatomical_structure Treatment Outcome Liver Cytokines medicine.drug Adult medicine.medical_specialty Mean arterial pressure Article Subject Urology Granulocyte General Biochemistry Genetics and Molecular Biology Extracorporeal Sepsis Norepinephrine (medication) 03 medical and health sciences Cytochrome P-450 CYP1A2 medicine Humans Aged Inflammation General Immunology and Microbiology Dose-Response Relationship Drug L-Lactate Dehydrogenase business.industry lcsh:R Extracorporeal circulation Hemodynamics 030208 emergency & critical care medicine medicine.disease Liver Artificial Survival Analysis Surgery Clinical Study Liver function tests business Biomarkers |
| Zdroj: | BioMed Research International BioMed Research International, Vol 2016 (2016) |
| ISSN: | 2314-6141 |
| Popis: | Purpose.Granulocyte transfusions have been used to treat immune cell dysfunction in sepsis. A granulocyte bioreactor for the extracorporeal treatment of sepsis was tested in a prospective clinical study focusing on the dosage of norepinephrine in patients and influence on dynamic and cell based liver tests during extracorporeal therapies.Methods and Patients.Ten patients with severe sepsis were treated twice within 72 h with the system containing granulocytes from healthy donors. Survival, physiologic parameters, extended hemodynamic measurement, and the indocyanine green plasma disappearance rate (PDR) were monitored. Plasma of patients before and after extracorporeal treatments were tested with a cell based biosensor for analysis of hepatotoxicity.Results.The observed mortality rate was 50% during stay in hospital. During the treatments, the norepinephrine-dosage could be significantly reduced while mean arterial pressure was stable. In the cell based analysis of hepatotoxicity, the viability and function of sensor-cells increased significantly during extracorporeal treatment in all patients and the PDR-values increased significantly between day 1 and day 7 only in survivors.Conclusion.The extracorporeal treatment with donor granulocytes showed promising effects on dosage of norepinephrine in patients, liver cell function, and viability in a cell based biosensor. Further studies with this approach are encouraged. |
| Databáze: | OpenAIRE |
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