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The extensive extracorporeal hemocatharsis therapy in local district hospital: the role of urologists in emergency medical crisis at local district Takehiro Sejima 1 , Manabu Shiono 1 , Hiroyuki Moriyama 2 , Tomoaki Kobayashi 2 , Jun Otani 3 1Department of Urology, Unnan Municipal General Hospital 2Department of Medical Engineer, Unnan Municipal General Hospital 3Department of Surgery, Unnan Municipal General Hospital Keyword: エンドトキシン吸着療法 , 血液浄化 , 地域医療 pp.795-800
Published Date 2008/9/20
DOI https://doi.org/10.11477/mf.1413101571
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 We have experienced 10 cases of extensive extracorporeal hemocatharsis therapy that were different from our usual institutional dialysis therapy. The details of 10 cases of the therapy were 2 leukocytapheresis(LCAP), 2 endotoxin absorption using polymyxin B-immobilized fiber, 3 continuous hemodiafiltration(CHDF), and 3 combination of endotoxin absorption and CHDF. All cases except 2 cases of LCAP presented severe infection and renal dysfunction. In these 8 cases, 4 patients died, 3 patients were transferred to other medical institutions which were suitable for more intensive therapy than our institution, and the one patient was rescued at our institution. These days, urologists have to manage such extensive extracorporeal hemocatharsis therapy because of absence of emergency medicine specialists at local district hospital in Japan. In such medical condition, renal dysfunction should be considered as the initial trigger of multiple organ failure, and sepsis should be considered from the point of view of systematic inflammatory response syndrome. Good medical cooperation between local and city hospitals is also mandatory.


Copyright © 2008, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1332 印刷版ISSN 0385-2393 医学書院

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