Extracorporeal organ support(ECOS)has made remarkable progress over the last few years.Renal replacement therapy,introduced a few decades ago,was the first available application of ECOS.The subsequent evolution of ECO...Extracorporeal organ support(ECOS)has made remarkable progress over the last few years.Renal replacement therapy,introduced a few decades ago,was the first available application of ECOS.The subsequent evolution of ECOS enabled the enhanced support to many other organs,including the heart[veno-arterial extracorporeal membrane oxygenation(ECMO),slow continuous ultrafiltration],the lungs(veno-venous ECMO,extracorporeal carbon dioxide removal),and the liver(blood purification techniques for the detoxification of liver toxins).Moreover,additional indications of these methods,including the suppression of excessive inflammatory response occurring in severe disorders such as sepsis,coronavirus disease 2019,pancreatitis,and trauma(blood purification techniques for the removal of exotoxins,endotoxins,or cytokines),have arisen.Multiple organ support therapy is crucial since a vast majority of critically ill patients present not with a single but with multiple organ failure(MOF),whereas,traditional therapeutic approaches(mechanical ventilation for acute respiratory failure,antibiotics for sepsis,and inotropes for cardiac dysfunction)have reached the maximum efficacy and cannot be improved further.However,several issues remain to be clarified,such as the complexity and cost of ECOS systems,standardization of indications,therapeutic protocols and initiation time,choice of the patients who will benefit most from these interventions,while evidence from randomized controlled trials supporting their use is still limited.Nevertheless,these methods are currently a part of routine clinical practice in intensive care units.This editorial presents the past,present,and future considerations,as well as perspectives regarding these therapies.Our better understanding of these methods,the pathophysiology of MOF,the crosstalk between native organs resulting in MOF,and the crosstalk between native organs and artificial organ support systems when applied sequentially or simultaneously,will lead to the multiplication of their effects and the minimization of complications arising from their use.展开更多
Blood purification refers to the extra corporeal therapies of removing potentially toxic substances, in which blood is circulated through an adsorption system loading separation materials. High-efficient inexpensive s...Blood purification refers to the extra corporeal therapies of removing potentially toxic substances, in which blood is circulated through an adsorption system loading separation materials. High-efficient inexpensive separation materials are critical to success. In this review, separation materials such as polymers and nanomaterials are summarized and compared. Combining the advantages of the adsorptive membranes and nanomaterials, organic–inorganic hybrid/blend membranes have been developed explosively. These hybrid/blend membranes have both the characteristics of high permeability, easy fabrication, good biocompatibility of adsorptive membranes, and characteristics of fast adsorption rate and high adsorption capacity of nanomaterials. The preparation and modification methodology of the separation materials is reviewed. For affinity separation materials, the relationship of ligand chemistry, ligand density and pores of the matrix is discussed. This paper also summarizes some interesting applications in separation materials for removal of bilirubin, endotoxin, toxic metal ions, cytokine, etc.展开更多
Since the global outbreak of COVID-19,membrane technology for clinical treatments,including extracorporeal membrane oxygenation(ECMO)and protective masks and clothing,has attracted intense research attention for its i...Since the global outbreak of COVID-19,membrane technology for clinical treatments,including extracorporeal membrane oxygenation(ECMO)and protective masks and clothing,has attracted intense research attention for its irreplaceable abilities.Membrane research and applications are now playing an increasingly important role in various fields of life science.In addition to intrinsic properties such as size sieving,dissolution and diffusion,membranes are often endowed with additional functions as cell scaffolds,catalysts or sensors to satisfy the specific requirements of different clinical applications.In this review,we will introduce and discuss state-of-the-art membranes and their respective functions in four typical areas of life science:artificial organs,tissue engineering,in vitro blood diagnosis and medical support.Emphasis will be given to the description of certain specific functions required of membranes in each field to provide guidance for the selection and fabrication of the membrane material.The advantages and disadvantages of these membranes have been compared to indicate further development directions for different clinical applications.Finally,we propose challenges and outlooks for future development.展开更多
文摘Extracorporeal organ support(ECOS)has made remarkable progress over the last few years.Renal replacement therapy,introduced a few decades ago,was the first available application of ECOS.The subsequent evolution of ECOS enabled the enhanced support to many other organs,including the heart[veno-arterial extracorporeal membrane oxygenation(ECMO),slow continuous ultrafiltration],the lungs(veno-venous ECMO,extracorporeal carbon dioxide removal),and the liver(blood purification techniques for the detoxification of liver toxins).Moreover,additional indications of these methods,including the suppression of excessive inflammatory response occurring in severe disorders such as sepsis,coronavirus disease 2019,pancreatitis,and trauma(blood purification techniques for the removal of exotoxins,endotoxins,or cytokines),have arisen.Multiple organ support therapy is crucial since a vast majority of critically ill patients present not with a single but with multiple organ failure(MOF),whereas,traditional therapeutic approaches(mechanical ventilation for acute respiratory failure,antibiotics for sepsis,and inotropes for cardiac dysfunction)have reached the maximum efficacy and cannot be improved further.However,several issues remain to be clarified,such as the complexity and cost of ECOS systems,standardization of indications,therapeutic protocols and initiation time,choice of the patients who will benefit most from these interventions,while evidence from randomized controlled trials supporting their use is still limited.Nevertheless,these methods are currently a part of routine clinical practice in intensive care units.This editorial presents the past,present,and future considerations,as well as perspectives regarding these therapies.Our better understanding of these methods,the pathophysiology of MOF,the crosstalk between native organs resulting in MOF,and the crosstalk between native organs and artificial organ support systems when applied sequentially or simultaneously,will lead to the multiplication of their effects and the minimization of complications arising from their use.
基金Supported by the National Natural Science Foundation of China(No.21606120)National Undergraducate Training Program for Innovation and Entrepreneurship(Nos.201710148000016 and 201810148080)
文摘Blood purification refers to the extra corporeal therapies of removing potentially toxic substances, in which blood is circulated through an adsorption system loading separation materials. High-efficient inexpensive separation materials are critical to success. In this review, separation materials such as polymers and nanomaterials are summarized and compared. Combining the advantages of the adsorptive membranes and nanomaterials, organic–inorganic hybrid/blend membranes have been developed explosively. These hybrid/blend membranes have both the characteristics of high permeability, easy fabrication, good biocompatibility of adsorptive membranes, and characteristics of fast adsorption rate and high adsorption capacity of nanomaterials. The preparation and modification methodology of the separation materials is reviewed. For affinity separation materials, the relationship of ligand chemistry, ligand density and pores of the matrix is discussed. This paper also summarizes some interesting applications in separation materials for removal of bilirubin, endotoxin, toxic metal ions, cytokine, etc.
基金financially supported by National Natural Science Foundation of China(22078148,22108120)the Natural Science Foundation of Jiangsu Province(BK20210549)the Top-notch Academic Programs Project of Jiangsu Higher Education Institutions(TAPP)。
文摘Since the global outbreak of COVID-19,membrane technology for clinical treatments,including extracorporeal membrane oxygenation(ECMO)and protective masks and clothing,has attracted intense research attention for its irreplaceable abilities.Membrane research and applications are now playing an increasingly important role in various fields of life science.In addition to intrinsic properties such as size sieving,dissolution and diffusion,membranes are often endowed with additional functions as cell scaffolds,catalysts or sensors to satisfy the specific requirements of different clinical applications.In this review,we will introduce and discuss state-of-the-art membranes and their respective functions in four typical areas of life science:artificial organs,tissue engineering,in vitro blood diagnosis and medical support.Emphasis will be given to the description of certain specific functions required of membranes in each field to provide guidance for the selection and fabrication of the membrane material.The advantages and disadvantages of these membranes have been compared to indicate further development directions for different clinical applications.Finally,we propose challenges and outlooks for future development.
