Critical Care Blood Purification for Acute Respiratory Distress Syndrome

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  • Hara,Yoshitaka
    Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine
  • Uchiyama,Sohta
    Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine
  • Katsuta,Ken
    Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine
  • Kawaji,Takahiro
    Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine
  • Isobe,Eri
    Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine
  • Wakako,Shoko
    Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine
  • Yamazoe,Yasuyoshi
    Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine
  • Nishida,Osamu
    Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine

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Other Title
  • Acute Respiratory Distress Syndromeの病態生理と急性血液浄化療法(<特集>急性期アフェレシスのup-to-date～各種臓器障害への対応～)

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The mortality in patients with acute respiratory distress syndrome (ARDS) remains high (30-40%), although it is showing a downward trend due to the advances in medicine and medical devices. In intensive care, blood purification has been widely used and established as a conventional renal replacement therapy. In Japan, blood purification for the purpose of mediator modulation has recently become widespread. Although there are retrospective reports supporting the effectiveness of polymyxin B-immobilized fiber column direct hemoperfusion (PMX-DHP) for patients with ARDS, when we look at the overall figures, there is little evidence for the effectiveness of blood purification for ARDS. Mediator modulation has become more and more important with the elucidation of the mechanism behind the pathophysiology of ARDS, focusing on the correlation among the major organs, e.g., between lungs and kidneys. In this review, we will focus on the pathophysiology of ARDS, including the association between the lungs and kidneys, and report a systematic review of the literature to assess the effects of blood purification for patients with ARDS.

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