Clinical use of plasmafiltration coupled with adsorption

Abstract

Coupled plasma filtration adsorption is an extracorporeal therapy that combines plasma separation and adsorption of inflammatory mediators and toxins, followed by hemofiltration to control volume overload and removal of small and medium-sized water-soluble mediators. Although it is not new, there are still doubts about its clinical role. Evidence indicates that the coupled plasma filtration adsorption is highly efficient in removing inflammatory molecules in sepsis. So far it has not been shown to reduce mortality, but it is possible to achieve a better hemodynamic benefit over convective therapies. On the other hand, the absorptive component makes it possible to purify larger mediators associated with causes of non-septic acute kidney injury, such as myoglobin, toxins associated with liver failure and others, allowing that coupled plasma filtration adsorption indications to be expanded to various clinical settings with a high inflammatory component, particularly when it is required to manage several organ dysfunctions simultaneously.