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2022, Número 2

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Rev Nefrol Dial Traspl 2022; 42 (2)


Uso clínico de la plasmafiltración acoplada con adsorción

Pedreros-Rosales C, Müller-Ortiz H, Colomina-Climent F

Idioma: Español
Referencias bibliográficas: 70
Paginas: 153-165
Archivo PDF: 431.5 Kb.


RESUMEN

La filtración de plasma acoplada con adsorción es una terapia extracorpórea que combina la separación de plasma y adsorción de mediadores inflamatorios y toxinas, seguida de hemofiltración para control de la sobrecarga de volumen y eliminación de mediadores hidrosolubles pequeños y medianos. Aunque no es nueva, aún existen dudas acerca de su rol clínico. La evidencia señala que la filtración de plasma acoplada con adsorción es altamente eficiente en remover moléculas inflamatorias en sepsis y, aunque hasta ahora no ha demostrado disminuir la mortalidad, si es posible conseguir mayor beneficio hemodinámico que las terapias convectivas. Por otra parte, el componente adsortivo permite depurar mediadores más grandes asociados a causas de lesión renal aguda no séptica, tales como mioglobina, toxinas asociadas con insuficiencia hepática y otros tóxicos, permitiendo expandir las indicaciones de filtración de plasma acoplada con adsorción a varios cuadros clínicos con gran componente inflamatorio, particularmente cuando se requiere manejar varias disfunciones orgánicas simultáneamente.


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