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The usefulness of extracorporeal membrane oxygenation (ECMO) is being rediscovered in the wake of the pandemic of H1N1 influenza. However, it has been reported that patients who received ECMO often developed virus-associated hemophagocytic syndrome (VAHS), compared with those without ECMO support. Although there is ample evidence that extensive cytokine activation is a key factor in VAHS, ECMO itself could be a potential trigger to exacerbate the pathology by amplifying cytokine activation. In this study, we investigated whether mediators such as cytokines may be produced by ECMO.

At ISICEM 2011, we reported that AN69ST showed the highest capacity to adsorb high mobility group box 1 protein (HMGB1) when compared with polymethylmethacrylate, polysulfone and high cut-off membrane [1]. Here we focus on whether filtration or surface heparin on AN69ST by a priming circuit with a heparinized saline contributes to HMGB1, with a heparin-binding protein, adsorption on AN69ST.

Sustained high-efficiency daily hemodiafiltration using a cytokine-adsorbing membrane (SHEDD-fA) is an effective modality for sepsis treatment. Here we describe the effectiveness of SHEDD-fA, which makes the best use of three principles for solute removal, in the treatment of severe sepsis.

SHEDD-fA is an effective modality that makes the best use of three principles in the treatment of severe sepsis: diffusion, convection and adsorption. We reported the efficacy of SHEDD-fA for the treatment of severe sepsis at the 31st ISICEM 2011 [1]. Here we present the blood clearance (CL) of seven important cytokines with SHEDD-fA.

The high mobility group box 1 protein (HMGB1) is an alarmin that plays an important role in sepsis. HMGB1 is hardly removable by normal hemofiltration because of its large molecular weight of 30 kDa. Here we show the possibility of removing HMGB1 from the blood.