Endothelial Protection and Improved Micro- and Macrocirculation with Hemoadsorption in Critically Ill Patients.

J Clin Med

Department of Anesthesiology and Intensive Therapy, Semmelweis University, 78 Üllői St., 1082 Budapest, Hungary.

Published: November 2024


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Article Abstract

A dysregulated immune response is associated with an excessive release of cytokines that can lead to systemic vasoplegia and vasoplegic shock with the development of multiorgan failure that is associated with an increased risk of dying. Under physiological circumstances, the endothelium and the glycocalyx are responsible for maintaining vascular tone, capillary permeability, and hemostasis, and controlling inflammation. In hyperinflammation, the endothelium and glycocalyx become damaged due to the excessive production of certain toxic proteins, along with an overwhelming release of cytokines. It has been shown in both in vitro animal experiments and in humans that extracorporeal hemoadsorption can reduce circulating levels of cytokines and may also remove toxic proteins that directly take part in endothelium and glycocalyx damage. The current review aims to summarize current knowledge, put recent findings into context, and introduce the hypothesis of "endothelial protection with hemoadsorption" in critically ill patients.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11642625PMC
http://dx.doi.org/10.3390/jcm13237044DOI Listing

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