Hemosorption - is passing blood in a specialapparatus through the artificial filter consisting of synthetic materials (e.g., activated carbon) which easily absorb and precipitate the "heavy" toxin molecule. hemosorption procedure involves returning the purified blood to the patient, while toxins caused pathological process remain sorption box.
The difference of efferent therapy methods isprocedure and in the effects exerted on the body. If plasmapheresis has great immunocorrective and reokorregiruyuschim (normalization of blood flow) effect, the hemosorbtion - great detoxifying effect.
The differences are based on biophysical laws: some are toxic substances in the structure of molecules of free radicals, i.e. they are electrically charged, so can be fixed on the sorbent; but many pathological agent have a closed structure and, therefore, are electrically neutral (e.g., immune complexes, some kinds of allergens, cholesterol, and others.). Electrically neutral substances do not stay sorbent. Accordingly, in this case, a more efficient procedure is plasmapheresis, in which the plasma is removed, together with soluble complexes of pathogens therein.
After the first procedure, significanta decrease in the concentration of pathological products, but after a few hours their concentration in the blood rises and approaches the initial one. This is explained by the fact that substances dissolved in tissue and cellular fluids actively enter the vascular bed. Subsequent efferent procedures can remove these substances, which ultimately leads to a decrease in the concentration of pathogenic substances in the body and prolonged remission (absence of manifestations of the disease) or even recovery. Therefore, to achieve a lasting positive effect, it is recommended that at least 3 procedures be performed.
The absolute indication for hemosorption remain acute poisoning.
Among the various extracorporeal methodshemocorrection hemosorption is distinguished by the simplicity of the circuit, the unnecessary costly equipment. The main active component of the circuit is hemosorbent. This is a granular carbon material subjected to activation, demineralization, depyrogenation, hydromechanical processing, ion balancing and sterilization. Hemosorbent is used to remove a wide range of substances of low and medium molecular weight, gram-negative bacterial flora and its endotoxins from the blood of patients.
Indications for hemosorption
The main indications for hemosorption are:
- withdrawal symptoms when drug addiction, substance abuse, alcoholism;
- manic and depressive states at mental diseases and conditions;
- acute poisoning hypnotic drugs, chlorine and organophosphorus compounds, alkaloids, salicylates, heavy metals.
Contraindications for hemosorption
The main contraindications for hemosorption are:
- all kinds of bleeding;
- violation of blood coagulation;
- BCC deficit;
- persistent hypotension;
- electrolyte disorders;
- hemodynamic instability;
- cardio-pulmonary insufficiency;
- severe liver and kidney function.