What is blood perfusion?
Blood perfusion, also named as hemoperfusion, is one of the commonly used blood purification techniques. Endogenous or exogenous toxins, as well as overdose of medicines, can be effectively eliminated after absorbed by the special adsorbents in the perfusion machine. Treatment effects can be achieved when the pathogenic factors are eliminated by adsorbents.
Adsorption is the process wherein the toxins in bloodstream are absorbed through use of special absorbents. There are two main methods, HA resin adsorption and DNA immune adsorption:
﹡HA resin adsorption
In HA resin adsorption, the adsorbents are neutral macroporous resins, and its adsorption function is mainly determined by molecular sieve effects of the three-dimensional mesh structure, charge gravitation of resin molecule group, and its lipophilic hydrophobic characteristics. It has relative specific adsorbent functions for the lipophilic hydrophobic groups.
﹡DNA immune adsorption
In DNA immune adsorption, spherical carbonized resins are carriers, calf thymus DNA antigens as ligands, and it specifically bind antinuclear antibodies in patients with Systemic Lupus Erythematosus (SLE).
The adsorption process is dominated by the four steps:
Diffusion process of the adsorbed substances in bloodstream, membrane diffusion, pore diffusion, and adsorption of the active sites on the adsorbent surfaces.
Under certain conditions, as the bloodstream is connected to solid adsorbents, the adsorbates in blood are absorbed by the adsorbents; after enough time, distribution of absorbents is balanced between the two sides, which will be called as adsorption balances. If otherwise the concentration in blood is higher, the adsorption process will continue.
In clinic, to relieve the discomforts of the patient, it is required that the adsorption process should be as short as possible which will maximally confirm adsorption effects. Generally the time should be limited within two to three hours.
How is hemoperfusion used in clinical practice?
Blood perfusion is highlighted in clinical treatment for kidney diseases, hepatic coma and severe immune related diseases. Its clinical use is often combined with other blood purification techniques. More details as reflected in the form:
( HP—hemoperfusion, HD—hemodialysis, CRRT—Continuous Renal Replacement Therapy, PE-peritoneal dialysis)
|Common remedial modes||indications|
|Poisoning||HP||All kinds of toxins or drug toxicity|
|Prevent such uremic complications as peripheral neuropathy, refractory itching and effusive pericarditis|
|Hepatic encephalopathy, hyperbilirubinemia and various kinds of liver damage caused by medicines or toxins|
|Critical illnesses||HD+HP CRRT+HP||Systemic inflammatory reaction syndrome, sepsis and multiple organ deficiencies|
|Immune diseases||HP+HD HP||Rheumatoid arthritis, Systemic Lupus Erythematosus(SLE), Henoch-Schonlein Purpura (HSP), etc|
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