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Bioartificial Therapy of Sepsis: Changes of Norepinephrine-Dosage in Patients and Influence on Dynamic and Cell Based Liver Tests during Extracorporeal Treatments.

Sauer M, Altrichter J, Haubner C, Pertschy A, Wild T, Doß F, Mencke T, Thomsen M, Ehler J, Henschel J, Doß S, Koch S, Richter G, Nöldge-Schomburg G, Mitzner SR - Biomed Res Int (2016)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Departments of Anesthesiology and Intensive Care Medicine, Medical Faculty of the University of Rostock, 18057 Rostock, Germany.

ABSTRACT
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.

No MeSH data available.


Related in: MedlinePlus

The dosage of norepinephrine (μg/kg/min) could be reduced significantly during the extracorporeal granulocyte treatments (Mann-Whitney U test; n = 10; median/0.25–0.75 quartile).
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fig2: The dosage of norepinephrine (μg/kg/min) could be reduced significantly during the extracorporeal granulocyte treatments (Mann-Whitney U test; n = 10; median/0.25–0.75 quartile).

Mentions: The dosage of norepinephrine could be reduced significantly during the extracorporeal treatments (Figure 2). Additionally, during the extracorporeal treatments, the mean arterial pressure, the heart rate, the parameters of hemodynamic monitoring using the PiCCO-System, the central venous oxygen saturation, and values of lactate showed no significant changes; but the cardiac index and stroke volume index increased (Table 4). After the second extracorporeal treatments of patients, the use of norepinephrine could reduce continue in the course of the observation time (data not shown).


Bioartificial Therapy of Sepsis: Changes of Norepinephrine-Dosage in Patients and Influence on Dynamic and Cell Based Liver Tests during Extracorporeal Treatments.

Sauer M, Altrichter J, Haubner C, Pertschy A, Wild T, Doß F, Mencke T, Thomsen M, Ehler J, Henschel J, Doß S, Koch S, Richter G, Nöldge-Schomburg G, Mitzner SR - Biomed Res Int (2016)

The dosage of norepinephrine (μg/kg/min) could be reduced significantly during the extracorporeal granulocyte treatments (Mann-Whitney U test; n = 10; median/0.25–0.75 quartile).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940519&req=5

fig2: The dosage of norepinephrine (μg/kg/min) could be reduced significantly during the extracorporeal granulocyte treatments (Mann-Whitney U test; n = 10; median/0.25–0.75 quartile).
Mentions: The dosage of norepinephrine could be reduced significantly during the extracorporeal treatments (Figure 2). Additionally, during the extracorporeal treatments, the mean arterial pressure, the heart rate, the parameters of hemodynamic monitoring using the PiCCO-System, the central venous oxygen saturation, and values of lactate showed no significant changes; but the cardiac index and stroke volume index increased (Table 4). After the second extracorporeal treatments of patients, the use of norepinephrine could reduce continue in the course of the observation time (data not shown).

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Departments of Anesthesiology and Intensive Care Medicine, Medical Faculty of the University of Rostock, 18057 Rostock, Germany.

ABSTRACT
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.

No MeSH data available.


Related in: MedlinePlus