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100 1 _ |a Parker, Robert
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245 _ _ |a Modeling and Hemofiltration Treatment of Acute Inflammation
260 _ _ |a Basel
|c 2016
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520 _ _ |a The body responds to endotoxins by triggering the acute inflammatory response system to eliminate the threat posed by gram-negative bacteria (endotoxin) and restore health. However, an uncontrolled inflammatory response can lead to tissue damage, organ failure, and ultimately death; this is clinically known as sepsis. Mathematical models of acute inflammatory disease have the potential to guide treatment decisions in critically ill patients. In this work, an 8-state (8-D) differential equation model of the acute inflammatory response system to endotoxin challenge was developed. Endotoxin challenges at 3 and 12 mg/kg were administered to rats, and dynamic cytokine data for interleukin (IL)-6, tumor necrosis factor (TNF), and IL-10 were obtained and used to calibrate the model. Evaluation of competing model structures was performed by analyzing model predictions at 3, 6, and 12 mg/kg endotoxin challenges with respect to experimental data from rats. Subsequently, a model predictive control (MPC) algorithm was synthesized to control a hemoadsorption (HA) device, a blood purification treatment for acute inflammation. A particle filter (PF) algorithm was implemented to estimate the full state vector of the endotoxemic rat based on time series cytokine measurements. Treatment simulations show that: (i) the apparent primary mechanism of HA efficacy is white blood cell (WBC) capture, with cytokine capture a secondary benefit; and (ii) differential filtering of cytokines and WBC does not provide substantial improvement in treatment outcomes vs. existing HA devices.
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700 1 _ |a Hogg, Justin
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700 1 _ |a Roy, Anirban
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700 1 _ |a Kellum, John
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700 1 _ |a Rimmelé, Thomas
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700 1 _ |a Daun-Gruhn, Silvia
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700 1 _ |a Fedorchak, Morgan
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700 1 _ |a Valenti, Isabella
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700 1 _ |a Federspiel, William
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700 1 _ |a Rubin, Jonathan
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700 1 _ |a Vodovotz, Yoram
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700 1 _ |a Lagoa, Claudio
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700 1 _ |a Clermont, Gilles
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773 _ _ |a 10.3390/pr4040038
|g Vol. 4, no. 4, p. 38 -
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