Las terapias adsortivas como coadyuvante al soporte vital en el paciente crítico

Abstract

Renal depurative therapies in acute situations are commonly used in intensive care units (ICU). The principles used for the replacement of renal function are convection, diffusion, and adsorption. Adsorption has been described as an effective principle for removing toxic substances from the blood using membranes and sorbents added to extracorporeal circuits. The regulation of pro-inflammatory mediators (“cytokine storm”) in the septic patient or protein-bound uraemic toxins is under investigation using these adsorptive depurative techniques. The potential of these therapies to eliminate endotoxins and cytokines in patients with or without acute kidney injury make them complementary interventions to be considered in the life support of critically ill patients. Currently, the following adsorptive therapies have been developed: MARS, Cytosorb®, CPFA, OXIRIS® and Seraph®. Critical care nurses are responsible for starting, monitoring, and managing the complete purification procedure, so their training and knowledge are essential for the success of these therapies.