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Risposta infiammatoria - Dove siamo? -

“ mixed ”. “ pro ”. “ anti ”. SIRS = Systemic inflammatory response syndrome. Infection. Sepsis. Death. Severe Sepsis. MODS. Hyper-inflammation. Normal. CARS = Compensatory anti-inflammatory response syndrome. Immunoparalysis. Risposta infiammatoria - Dove siamo? -.

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Risposta infiammatoria - Dove siamo? -

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  1. “mixed” “pro” “anti” SIRS = Systemic inflammatory response syndrome Infection Sepsis Death Severe Sepsis MODS Hyper-inflammation Normal CARS = Compensatory anti-inflammatoryresponse syndrome Immunoparalysis Risposta infiammatoria- Dove siamo? -

  2. Int J Artif Organ 2002; 25: 733-47

  3. Stimolo endotossinico TNF LPS IL-1 IL-10 IL-6 IL-8 Concentrazione plasmatica C.P.F.A. tempo RISPOSTA PRO E ANTI-INFIAMMATORIA Peak concentration hypotesis RONCO et all

  4. LPS LPS 0.05 mg/kg 0.05 mg/kg Coupled Plasma Filtration Adsorption Modello dello shock settico 1.0 PF R+ 16/20 (80%) R 0.8 no. 20 0.6 Sopravvivenza Cumulativa 0.4 PF L+ 5/19 (25%) 0.2 no. 19 0 0 2 4 6 8 giorni Miglioramento della sopravvivenza senza correlazione con i livelli plasmatici di TNF e PAF Tetta C et al. Crit Care Med 2000; 28: 1526-33

  5. Hemodynamic response to coupled plasmafiltration-adsorption in human septic shock Marco Formica, Carlo Olivieri, Sergio Livigni, Giulio Cesano, Antonella Vallero, Mariella Maio and Ciro Tetta Intensive Care Med (2003) 29: 703-708 Objective: The objective was to examine the effect of repeated applications of coupled plasmafiltration-adsorption on the hemodynamic response in septic shock patients hospitalized in intensive care units (ICUs). Conclusion: Coupled plasmafiltration-adsorption was a feasible and safe extracorporeal treatment and exerted a remarkable improvement in the hemodynamic, the pulmonary function, and the outcome in septic shock patients with or without concomitant ARF.

  6. PLASMAFILTRAZIONE E ADSORBIMENTO ASSOCIATE (CPFA) • LYNDA (Bellco, Mirandola, Italia) • Plasmafiltro (Polieteresulfone MICROPES® 0.45 m2 cut-off di circa 800 kDa) • Cartuccia di resine idrofobiche (140 ml per 70 gr, con superficie adsorbente di circa 700 m2/gr) • Emofiltro (Polieteresulfone DIAPES®-HF 1.2 m2, CVVH, CVVHD)

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