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Therapeutic applications

Acute blood purification options

Ģý supports a wide range of acute blood purification options, primarily in intensive care.

Continuous kidney replacement therapy (CKRT)

Continuous kidney replacement therapy (CKRT)

As its name suggests, CKRT is intended to continuously replace certain kidney functions. This therapy is preferable for hemodynamically unstable patients or patients at risk for increased intracranial pressure as it enables continuous management of patient fluid volume and a slow but steady removal of toxins.1

CKRT includes convective and diffusive therapy modalities, e.g.:

  • Continuous veno-venous hemodialysis (CVVHD)
  • Continuous veno-venous hemofiltration (CVVH)
  • Continuous veno-venous hemodiafiltration (CVVHDF)
Continuous kidney replacement therapy (CKRT)

Efficient anticoagulation of the extracorporeal blood circuit is essential for reliable renal replacement therapy. Following the KDIGO AKI clinical practice guideline, regional citrate anticoagulation has become widely accepted in a number of countries.1,2

To provide reliable regional citrate anticoagulation, Ģý developed its comprehensiveCiĢýCa therapytogether with experienced clinicians. Since its introduction, healthcare professionals in over 30 countries have gained experience with CiĢýCa therapy.

CKRT and reduction of pathogens and cytokines

CKRT and reduction of pathogens and cytokines

Targeting beyond the removal of uremic toxins with CKRT devices may be an option to consider when treating critically ill patients with incipient or advanced sepsis or septic shock.

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to an infection.3An uncontrolled inflammatory response often leads to severe and life-threatening hemodynamic instability and multiple organ dysfunction syndrome (MODS).

Reducing the peaks of the cytokine concentration typically involved in the inflammatory response with a continuously acting therapy such as CKRT has been proposed as a reasonable approach.4Moreover, pathogen adsorption may represent a promising tool as binding to a purpose-created surface may reduce pathogens in blood stream infections.5

Our multiFiltratePRO device allows the application of certain whole-blood adsorbers designed to

  • reduce circulating pathogens in adjunction to antibiotic treatment in case of blood stream infection (Seraph100*)
  • adsorb various cytokines, bilirubin, and myoglobin (CytoSorb*)

* Seraph 100 Microbind Affinity Blood Filter and CytoSorb 300 mL are compatible with multiFiltratePRO and multiFiltratedevices. Legal manufacturer of Seraph 100 is ExThera Medical Corp., USA. Legal manufacturer of CytoSorb is CytoSorbents Corporation, USA.

CO2 removal in combination with CKRT

CO2removal in combination with CKRT

Kidney and lung are deeply interconnected and their respective acute failures can strongly influence one another.6A substantial number of patients suffer from both ARDS requiring mechanical ventilation and AKI. For such patients, combining ECCO2R with CKRT in a single extracorporeal circuit has been suggested as an attractive therapeutic option.7

Blood-gas exchangers enable extracorporeal carbon dioxide removal (ECCO2R) and may support the management of acute respiratory dysfunction syndrome (ARDS) by removing excessive CO2from the bloodstream.8

ճmultiECCO2R* gas exchanger enables the delivery of low-flow ECCO2R in combination with CKRT simultaneously on a single therapy system using one vascular access.9

* Legal manufacturer of multiECCO2Ris EUROSETS S.r.l., Italy. Ģý Deutschland GmbH is a distributor of multiECCO2Rin selected countries.

Therapeutic plasma exchange

Therapeutic plasma exchange

Therapeutic plasma exchange (TPE) is a well-established extracorporeal blood purification technique supporting the Ģýremoval of pathological substances from the blood, such as monoclonal paraproteins and autoantibodies, as well as the replacement of deficient plasma components when plasma is used as a replacement fluid.Ģý10

Indications for TPE cover selected diagnoses from different specialities such as neurology, hematology, rheumatology and nephrology.10

Our CKRT devicemultiFiltratePROsupports a convenient delivery of TPE with comprehensive user guidance and integrated automated plasma volume calculation according to Sprenger et al.11, as well as an automated ramp-up of plasma separation. Plasma and blood cells are separated by using one of our validatedplasmaFluxfilters.

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    1KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int Suppl 2012; 2:1-138

    2Kindgen-Milles D et al. Curr Opin Crit Care 2018; 24:450Ģý454

    3Singer M et al. JAMA 2016; 315(8):801Ģý810

    4Ronco C et al. Artif Organs 2003; 27(9):792Ģý801

    5Monard C et al. Blood Purif 2022; doi: 10.1159/000524973

    6Singbartl K. Contrib Nephrol 2011; 174:65Ģý70

    7Jacobs et al. Respir Care 2020; 65(4):517Ģý524

    8Morimont P et al. Crit Care 2015; 19:117

    9Husain-Syed F et al. Front Med 2020; 7:598379

    10Reeves HM et al. Br J Haematol. 2014; 164:342Ģý351

    11Sprenger KB et al. J Clin Apher 1987; 3:185Ģý190

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