Uso clínico de la plasmafiltración acoplada con adsorción
Resumen
La filtración de plasma acoplada con adsorción es una terapia extracorpórea que combina la separación de plasma y adsorción de mediadores inflamatorios y toxinas, seguida de hemofiltración para control de la sobrecarga de volumen y eliminación de mediadores hidrosolubles pequeños y medianos. Aunque no es nueva, aún existen dudas acerca de su rol clínico. La evidencia señala que la filtración de plasma acoplada con adsorción es altamente eficiente en remover moléculas inflamatorias en sepsis y, aunque hasta ahora no ha demostrado disminuir la mortalidad, si es posible conseguir mayor beneficio hemodinámico que las terapias convectivas. Por otra parte, el componente adsortivo permite depurar mediadores más grandes asociados a causas de lesión renal aguda no séptica, tales como mioglobina, toxinas asociadas con insuficiencia hepática y otros tóxicos, permitiendo expandir las indicaciones de filtración de plasma acoplada con adsorción a varios cuadros clínicos con gran componente inflamatorio, particularmente cuando se requiere manejar varias disfunciones orgánicas simultáneamente.
Citas
2) Ankawi G, Neri M, Zhang J, Breglia A, Ricci Z, Ronco C. Extracorporeal techniques for the treatment of critically ill patients with sepsis beyond conventional blood purification therapy: the promises and the pitfalls. Crit Care. 2018;22(1):262. doi: 10.1186/s13054-018-2181-z.
3) Berlot G, Di Capua G, Nosella P, Rocconi S, Thomann C. Plasmapheresis in sepsis. Contrib Nephrol. 2004;144:387-94. doi: 10.1159/000078904.
4) Davies B, Cohen J. Endotoxin removal devices for the treatment of sepsis and septic shock. Lancet Infect Dis. 2011;11(1):65-71. doi: 10.1016/S1473-3099(10)70220-6.
5) Bellomo R, Tetta C, Ronco C. Coupled plasma filtration adsorption. Intensive Care Med. 2003;29(8):1222-8. doi: 10.1007/s00134-003-1796-x.
6) Girardot T, Schneider A, Rimmelé T. Blood Purification Techniques for Sepsis and Septic AKI. Semin Nephrol. 2019;39(5):505-14. doi: 10.1016/j.semnephrol.2019.06.010.
7) La Manna G, Donati G. Coupled plasma filtration adsorption: A multipurpose extracorporeal detoxification therapy. Blood Purif. 2018;46(3):228-38. doi: 10.1159/000490234.
8) Morgera S, Rocktäschel J, Haase M, Lehmann C, von Heymann C, Ziemer S, et al. Intermittent high permeability hemofiltration in septic patients with acute renal failure. Intensive Care Med. 2003;29(11):1989-95. doi: 10.1007/s00134-003-2003-9.
9) Li J, Li D, Xu Y, Wang A, Xu C, Yu C. The optimal timing of hemoperfusion component in combined hemodialysis-hemoperfusion treatment for uremic toxins removal. Ren Fail. 2015;37(1):103-7. doi: 10.3109/0886022X.2014.976131.
10) Park S, Islam MI, Jeong JH, Cho NJ, Song HY, Lee EY, et al. Hemoperfusion leads to impairment in hemostasis and coagulation process in patients with acute pesticide intoxication. Sci Rep. 2019;9(1):13325. doi: 10.1038/s41598-019-49738-1.
11) Ronco C, Brendolan A, d'Intini V, Ricci Z, Wratten ML, Bellomo R. Coupled plasma filtration adsorption: rationale, technical development and early clinical experience. Blood Purif. 2003;21(6):409-16. doi: 10.1159/000073444.
12) Tetta C, Cavaillon JM, Schulze M, Ronco C, Ghezzi PM, Camussi G, et al. Removal of cytokines and activated complement components in an experimental model of continuous plasma filtration coupled with sorbent adsorption. Nephrol Dial Transplant. 1998;13(6):1458-64. doi: 10.1093/ndt/13.6.1458.
13) Tetta C, Gianotti L, Cavaillon JM, Wratten ML, Fini M, Braga M, et al. Coupled plasma filtration-adsorption in a rabbit model of endotoxic shock. Crit Care Med. 2000;28(5):1526-33. doi: 10.1097/00003246-200005000-00045.
14) Sykora R, Chvojka J, Krouzecky A, Radej J, Kuncova J, Varnerova V, et al. Coupled plasma filtration adsorption in experimental peritonitis-induced septic shock. Shock. 2009;31(5):473-80. doi: 10.1097/SHK.0b013e318188dec5.
15) Bouman CS, Oudemans-van Straaten HM, Schultz MJ, Vroom MB. Hemofiltration in sepsis and systemic inflammatory response syndrome: the role of dosing and timing. J Crit Care. 2007;22(1):1-12. doi: 10.1016/j.jcrc.2006.05.002.
16) Bagshaw SM, Wald R. Strategies for the optimal timing to start renal replacement therapy in critically ill patients with acute kidney injury. Kidney Int. 2017;91(5):1022-32. doi: 10.1016/j.kint.2016.09.053.
17) Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving sepsis campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Med. 2017;43(3):304-77. doi: 10.1007/s00134-017-4683-6.
18) Lentini P, Cruz D, Nalesso F, de Cal M, Bobek I, Garzotto F, et al. Coupled plasma filtration adsorption (CPFA) versus emofiltrazione continua con regime intermittente di alti volumi (pHVHF) nel trattamento dello shock settico: uno studio pilota. G Ital Nefrol. 2009;26(6):695-703.
19) Ronco C, Brendolan A, Lonnemann G, Bellomo R, Piccinni P, Digito A, et al. A pilot study of coupled plasma filtration with adsorption in septic shock. Crit Care Med. 2002;30(6):1250-5. doi: 10.1097/00003246-200206000-00015.
20) Formica M, Olivieri C, Livigni S, Cesano G, Vallero A, Maio M, et al. Hemodynamic response to coupled plasmafiltration-adsorption in human septic shock. Intensive Care Med. 2003;29(5):703-8. doi: 10.1007/s00134-003-1724-0.
21) Berlot G, Agbedjro A, Tomasini A, Bianco F, Gerini U, Viviani M, et al. Effects of the volume of processed plasma on the outcome, arterial pressure and blood procalcitonin levels in patients with severe sepsis and septic shock treated with coupled plasma filtration and adsorption. Blood Purif. 2014;37(2):146-51. doi: 10.1159/000360268.
22) Hu D, Sun S, Zhu B, Mei Z, Wang L, Zhu S, et al. Effects of coupled plasma filtration adsorption on septic patients with multiple organ dysfunction syndrome. Ren Fail. 2012;34(7):834-9. doi: 10.3109/0886022X.2012.684553.
23) Turani F, Falco M, Natoli S, Leonardis F, Fede M, Berlot G, et al. Coupled plasma filtration and adsorption in septic shock: a multicentric experience. Crit Care. 2010;14(Suppl. 1):P412. doi: 10.1186/cc8644.
24) Berlot G, Bianco N, Tomasini A, Vassallo MC, Bianco F. Changes in microvascular blood flow during coupled plasma filtration and adsorption. Anaesth Intensive Care. 2011;39(4):687-9. doi: 10.1177/0310057X110390042.
25) Livigni S, Bertolini G, Rossi C, Ferrari F, Giardino M, Pozzato M, et al; GiViTI: Gruppo Italiano per la Valutazione degli Interventi in Terapia Intensiva. Efficacy of coupled plasma filtration adsorption (CPFA) in patients with septic shock: a multicenter randomised controlled clinical trial. BMJ Open. 2014;4(1):e003536. doi: 10.1136/bmjopen-2013-003536.
26) Garbero E, Livigni S, Ferrari F, Finazzi S, Langer M, Malacarne P, et al.; GiViTI: Gruppo Italiano per la Valutazione degli Interventi in Terapia Intensiva. High dose coupled plasma filtration and adsorption in septic shock patients. Results of the COMPACT-2: a multicentre, adaptive, randomised clinical trial. Intensive Care Med. 2021;47(11):1303-11. doi: 10.1007/s00134-021-06501-3.
27) Colomina-Climent F, Giménez-Esparza C, Portillo-Requena C, Allegue-Gallego JM, Galindo-Martínez M, Mollà-Jiménez C, et al. Mortality reduction in septic shock by plasma adsorption (ROMPA): a protocol for a randomised clinical trial. BMJ Open. 2016;6(7):e011856. doi: 10.1136/bmjopen-2016-011856.
28) Giménez-Esparza C, Portillo-Requena C, Colomina-Climent F, Allegue-Gallego JM, Galindo-Martínez M, Mollà-Jiménez C, et al. The premature closure of ROMPA clinical trial: mortality reduction in septic shock by plasma adsorption. BMJ Open. 2019;9(12):e030139. doi: 10.1136/bmjopen-2019-030139.
29) Berlot G, Falini S, Negro V, Agbedjro A, Tomasini A, Iscra F, et al. Influence of timing of initiation and volume of processed plasma on the outcome of septic shock patients treated with coupled plasma filtration and adsorption. Blood Purif. 2018;46(4):274-78. doi: 10.1159/000490611.
30) Vassallo MC, Tartamella F, Bhakta P. Regional citrate anticoagulation during coupled plasma filtration and adsorption may increase survival in septic shock. Blood Purif. 2019;47(1-3):109-110. doi: 10.1159/000493538.
31) Berlot G, Falini S, Negro V, Agbedjro A, Tomasini A, Iscra F, et al. Regional citrate anticoagulation during coupled plasma filtration and adsorption may increase survival in septic shock. Blood Purif. 2019;47(1-3):111-2. doi: 10.1159/000493539.
32) Mariano F, Morselli M, Holló Z, Agostini F, Stella M, Biancone L. Citrate pharmacokinetics at high levels of circuit citratemia during coupled plasma filtration adsorption. Nephrol Dial Transplant. 2015;30(11):1911-9. doi: 10.1093/ndt/gfv290.
33) Borthwick EM, Hill CJ, Rabindranath KS, Maxwell AP, McAuley DF, Blackwood B. High-volume haemofiltration for sepsis in adults. Cochrane Database Syst Rev. 2017;1(1):CD008075. doi: 10.1002/14651858.CD008075.pub3.
34) Joannes-Boyau O, Rapaport S, Bazin R, Fleureau C, Janvier G. Impact of high-volume hemofiltration on hemodynamic disturbance and outcome during septic shock. ASAIO J. 2004;50(1):102-9. doi: 10.1097/01.mat.0000104846.27116.ea.
35) Schefold JC, Hasper D, Jörres A. Organ crosstalk in critically ill patients: hemofiltration and immunomodulation in sepsis. Blood Purif. 2009;28(2):116-23. doi: 10.1159/000223361.
36) Lelubre C, Vincent JL. Mechanisms, and treatment of organ failure in sepsis. Nat Rev Nephrol. 2018;14(7):417-27. doi: 10.1038/s41581-018-0005-7.
37) Oyama Y, Takeda T, Hama H, Tanuma A, Iino N, Sato K, et al. Evidence for megalin-mediated proximal tubular uptake of L-FABP, a carrier of potentially nephrotoxic molecules. Lab Invest. 2005;85(4):522-31. doi: 10.1038/labinvest.3700240.
38) Castellano G, Stasi A, Intini A, Gigante M, Di Palma AM, Divella C, et al. Endothelial dysfunction and renal fibrosis in endotoxemia-induced oliguric kidney injury: possible role of LPS-binding protein. Crit Care. 2014;18(5):520. doi: 10.1186/s13054-014-0520-2.
39) Panitchote A, Mehkri O, Hastings A, Hanane T, Demirjian S, Torbic H, et al. Factors associated with acute kidney injury in acute respiratory distress syndrome. Ann Intensive Care. 2019 Jul 1;9(1):74. doi: 10.1186/s13613-019-0552-5.
40) Husain-Syed F, Slutsky AS, Ronco C. Lung-kidney cross-talk in the critically ill patient. Am J Respir Crit Care Med. 2016;194(4):402-14. doi: 10.1164/rccm.201602-0420CP.
41) Lucisano G, Capria M, Matera G, Presta P, Comi N, Talarico R, et al. Coupled plasma filtration adsorption for the treatment of a patient with acute respiratory distress syndrome and acute kidney injury: a case report. NDT Plus. 2011;4(5):285-8. doi: 10.1093/ndtplus/sfr081.
42) Oberholzer A, Souza SM, Tschoeke SK, Oberholzer C, Abouhamze A, Pribble JP, et al. Plasma cytokine measurements augment prognostic scores as indicators of outcome in patients with severe sepsis. Shock. 2005;23(6):488-93.
43) Bonavia A, Miller L, Kellum JA, Singbartl K. Hemoadsorption corrects hyperresistinemia and restores anti-bacterial neutrophil function. Intensive Care Med Exp. 2017;5(1):36. doi: 10.1186/s40635-017-0150-5.
44) Shukla P, Rao GM, Pandey G, Sharma S, Mittapelly N, Shegokar R, et al. Therapeutic interventions in sepsis: current and anticipated pharmacological agents. Br J Pharmacol. 2014;171(22):5011-31. doi: 10.1111/bph.12829.
45) Cortegiani A, Ippolito M, Greco M, Granone V, Protti A, Gregoretti C, et al. Rationale and evidence on the use of tocilizumab in COVID-19: a systematic review. Pulmonology. 2020:S2531-0437(20)30153-7. doi: 10.1016/j.pulmoe.2020.07.003.
46) Furlow B. COVACTA trial raises questions about tocilizumab's benefit in COVID-19. Lancet Rheumatol. 2020;2(10):e592. doi: 10.1016/S2665-9913(20)30313-1.
47) Pawar A, Desai RJ, Solomon DH, Santiago Ortiz AJ, Gale S, Bao M, et al. Risk of serious infections in tocilizumab versus other biologic drugs in patients with rheumatoid arthritis: a multidatabase cohort study. Ann Rheum Dis. 2019;78(4):456-64. doi: 10.1136/annrheumdis-2018-214367.
48) Bonavia A, Groff A, Karamchandani K, Singbartl K. Clinical utility of extracorporeal cytokine hemoadsorption therapy: A literature review. Blood Purif. 2018;46(4):337-49. doi: 10.1159/000492379.
49) Ronco C, Reis T, De Rosa S. Coronavirus epidemic and extracorporeal therapies in intensive care: si vis pacem para bellum. Blood Purif. 2020;49(3):255-8. doi: 10.1159/000507039.
50) Esmaeili Vardanjani A, Ronco C, Rafiei H, Golitaleb M, Pishvaei MH, Mohammadi M. Early hemoperfusion for cytokine removal may contribute to prevention of intubation in patients infected with COVID-19. Blood Purif. 2020:1-4. doi: 10.1159/000509107.
51) Azoulay E, Zafrani L, Mirouse A, Lengliné E, Darmon M, Chevret S. Clinical phenotypes of critically ill COVID-19 patients. Intensive Care Med. 2020;46(8):1651-2. doi: 10.1007/s00134-020-06120-4.
52) van der Made CI, Simons A, Schuurs-Hoeijmakers J, van den Heuvel G, Mantere T, Kersten S, et al. Presence of genetic variants among young men with severe COVID-19. JAMA. 2020;324(7):663-73. doi: 10.1001/jama.2020.13719.
53) Siddall E, Khatri M, Radhakrishnan J. Capillary leak syndrome: etiologies, pathophysiology, and management. Kidney Int. 2017;92(1):37-46. doi: 10.1016/j.kint.2016.11.029.
54) El-Azhary RA, Wang MZ, Wentworth AB, Hickson LJ. Treatment of severe drug reactions by hemodialysis. Int J Dermatol. 2018;57(2):177-82. doi: 10.1111/ijd.13837.
55) Kapoor P, Greipp PT, Schaefer EW, Mandrekar SJ, Kamal AH, Gonzalez-Paz NC, et al. Idiopathic systemic capillary leak syndrome (Clarkson's disease): The Mayo clinic experience. Mayo Clin Proc. 2010;85(10):905-12. doi: 10.4065/mcp.2010.0159.
56) Di Maso V, Cozzi M, Gerini U, Bedina E, Olivo E, Bianco F, et al. Coupled plasma filtration adsorption for treatment of capillary leak syndrome superimposed to acute generalized exanthematous pustolosis: A case report. Blood Purif. 2020;49(3):372-8. doi: 10.1159/000503770.
57) Maggi U, Nita G, Gatti S, Antonelli B, Paolo R, Como G, et al. Hyperbilirubinemia after liver transplantation: the role of coupled plasma filtration adsorption. Transplant Proc. 2013;45(7):2715-7. doi: 10.1016/j.transproceed.2013.07.019.
58) Caroleo S, Rubino AS, Tropea F, Bruno O, Vuoto D, Amantea B, et al. Coupled plasma filtration adsorption reduces serum bilirubine in a case of acute hypoxic hepatitis secondary to cardiogenic shock. Int J Artif Organs. 2010;33(10):749-52.
59) Donati G, Angeletti A, Gasperoni L, Piscaglia F, Croci Chiocchini AL, Scrivo A, et al. Detoxification of bilirubin and bile acids with intermittent coupled plasmafiltration and adsorption in liver failure (HERCOLE study). J Nephrol. 2021;34(1):77-88. doi: 10.1007/s40620-020-00799-w.
60) Zimmerman JL, Shen MC. Rhabdomyolysis. Chest. 2013;144(3):1058-65. doi: 10.1378/chest.12-2016.
61) Lai Q, Di Pietro V, Iesari S, Amabili S, De Luca L, Clemente K, et al. Coupled plasma filtration adsorption in patients with a history of kidney transplantation: report of two cases. Blood Purif. 2015;40(3):218-22. doi: 10.1159/000437042.
62) Pezzi M, Renda S, Giglio AM, Scozzafava AM, Tiburzi SP, Casella P, et al. The use of coupled plasma filtration adsorption in traumatic rhabdomyolysis. Case Rep Crit Care. 2017;2017:5764961. doi: 10.1155/2017/5764961.
63) Osman C, Jennings R, El-Ghariani K, Pinto A. Plasma exchange in neurological disease. Pract Neurol. 2020;20(2):92-9. doi: 10.1136/practneurol-2019-002336.
64) Reeves HM, Winters JL. The mechanisms of action of plasma exchange. Br J Haematol. 2014;164(3):342-51. doi: 10.1111/bjh.12629.
65) Schneider-Gold C, Krenzer M, Klinker E, Mansouri-Thalegani B, Müllges W, Toyka KV, et al. Immunoadsorption versus plasma exchange versus combination for treatment of myasthenic deterioration. Ther Adv Neurol Disord. 2016;9(4):297-303. doi: 10.1177/1756285616637046.
66) Dorst J, Fangerau T, Taranu D, Eichele P, Dreyhaupt J, Michels S, et al. Safety and efficacy of immunoadsorption versus plasma exchange in steroid-refractory relapse of multiple sclerosis and clinically isolated syndrome: A randomised, parallel-group, controlled trial. EClinicalMedicine. 2019;16:98-106. doi: 10.1016/j.eclinm.2019.10.017.
67) Fabbri LP, Macchi A, Lecchini R, Pennacchi A. Post influenza vaccination Guillain-Barré syndrome: an exceptional recovery case after cardiac arrest for two hours in hyperthermia and septic shock. Anaest Pain Intensive Care 2015;19:166-9.
68) Ghannoum M, Roberts DM, Hoffman RS, Ouellet G, Roy L, Decker BS, et al. A stepwise approach for the management of poisoning with extracorporeal treatments. Semin Dial. 2014;27(4):362-70. doi: 10.1111/sdi.12228.
69) Winchester JF, Harbord NB, Rosen H. Management of poisonings: core curriculum 2010. Am J Kidney Dis. 2010;56(4):788-800. doi: 10.1053/j.ajkd.2010.05.014.
70) Donati G, Capelli I, Croci Chiocchini AL, Natali N, Scrivo A, La Manna G. Coupled plasma filtration adsorption application for liver and thyroid toxins. Contrib Nephrol. 2017;190:31-42. doi: 10.1159/000468909.
Derechos de autor 2022 Revista de Nefrología, Diálisis y Trasplante
Esta obra está bajo licencia internacional Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0.