الفهرس 
History &evolution of extracorporeal blood purificationOnly 14 pages are availabe for public view
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Abstract
The aim of this essay is to show that advances and innovations in healthcare technology are instrumental in reshaping the healthcare system and in impacting the practice of medicine, including critical care. Extracorporeal Blood purification in critical care is one of the technologies which have many indications and have many methods that were discussed in the essay. Acute kidney injury is a major indication, but there are also non-renal indications for the extracorporeal blood purification in icu. Blood purification in critical care is performed not only by hemodialysis or hemofiltration using hemofilters, but also various other methods such as apheresis and adsorption.
Blood purification in critical care can perform 2 main functions: 1-As an artificial support for failing organs (such as artificial kidney or liver support). 2- As a remover of causative humoral mediators of critical illness (such as severe sepsis and acute respiratory distress syndrome). The emergence of dialytic support for patients with reversible renal failure was one of the most significant advances in critical care medicine. Supporting a patient with a failed organ till organ recovery has not had the same success with other organ failures. Despite the indispensable nature of the support, dialysis was intermittent at best, and carried its own morbidity. The emergence of a ”continuous” dialysis delivery system, originally through an arteriovenous access and later through veno-venous methodology, began to simulate the continuity of the natural kidney, and lifted much of the fluid and drug restrictions imposed by the intermittent nature of standard dialytic therapies. Components of the system were next reviewed for improvement and biocompatibility concerning blood purification and the removal of causative humoral mediators of critical illness, CHDF using a hemofilter made from polymethylmethacrylate membrane is reported to be very effective in the treatment of severe sepsis and septic shock, even in septic patients without renal dysfunction. Thus, CHDF with a polymethylmethacrylate membrane is now widely applied for non-renal indications, not only for patients with sepsis but also patients with cytokine-induced critical illness (such as acute respiratory distress syndrome and severe acute pancreatitis), even when those patients do not present with renal dysfunction or renal failure. Blood purification in critical care is gaining popularity, and is widely for both renal and non-renal indications…………..