Blood filtering of inflammatory biomarkers to treat post-resuscitation syndrome

Abstract

Provided is a therapeutic device that includes tubing; at least one pump; and a column or filter capable of removing leukocytes, cytokines, and/or other blood components from the blood of a patient to effectively treat or prevent post-resuscitation syndrome. Methods for treating and/or preventing post-resuscitation syndrome that include the use of such a device, or a filter or column capable of selectively removing inflammatory biomarkers, are also provided.

1 - 45 . (canceled) 
     
     
         46 . A method for treating or preventing ischemia in a subject, comprising:
 removing blood from a subject, comprising moving the blood from the subject through a first portion of a circuit comprising a first portion of tubing;   passing the removed blood from the first portion of the circuit through a filter at a blood flow rate of 4-24 L per hour to selectively remove blood components comprising one or more of: leukocytes, cytokines, interleukins, tumor necrosis factor α (TNF-α), c-reactive protein (CRP), nuclear factor-kappa B (NF-KB) subunit p65, interferon-γ, elastase, inducible NO synthase, heme oxygenase-1, free radicals, intracellular adhesion molecules, vascular cell adhesion 55 molecule-I, complement components, granulocyte-macrophage colony-stimulating factor (GM-CSF), monocyte chemoattractant protein-I (MCP-1), Regulated on Activation, Normal T Cell Expressed and Secreted (RANTES) protein, and von Willibrand factor (VWF); and   returning the filtered blood to the subject, comprising passing the filtered blood to the subject via a second portion of the circuit comprising a second portion of tubing.   
     
     
         47 . The method of  claim 46 , wherein the selectively removing the blood components comprises removing the interleukins comprising at least one of IL-1β, IL-2, IL-4, IL-6, IL-10, and IL-15. 
     
     
         48 . The method of  claim 46 , wherein the selectively removing the blood components comprises removing the intracellular adhesion molecules comprising at least one of ICAM1, ICAM2, ICAM3, ICAM4 and ICAM 5. 
     
     
         49 . The method of  claim 46 , wherein the selectively removing the blood components comprises removing free radicals comprising at least one of free iron radicals and free oxygen radicals. 
     
     
         50 . The method of  claim 46 , wherein the selectively removing the blood components comprises removing complement components comprising at least one of C3a and terminal complement complex (TCC). 
     
     
         51 . The method of  claim 46 , wherein the removing of the blood from the subject comprises using a catheter inserted into the patient's body for use in carrying extracting the blood. 
     
     
         52 . The method of  claim 46 , comprising oxygenating the blood prior to returning the filtered blood to the subject. 
     
     
         53 . The method of  claim 52 , comprising oxygenating the blood using an oxygenator in supplying oxygen to be added to the blood. 
     
     
         54 . The method of  claim 52 , wherein the method is used to treat ischemia. 
     
     
         55 . The method of  claim 54 , wherein the method is used to treat ischemia following a heart attack. 
     
     
         56 . The method of  claim 54 , wherein the method used to treat ischemia following a cardiac arrest. 
     
     
         57 . The method of  claim 52 , wherein the method is used to treat one or more of post-cardiac arrest brain injury, post-cardiac arrest myocardial dysfunction, reperfusion response, persistent pathology, cardiovascular disease, pulmonary disease, CNS disease, infection, hemorrhage, and dehydration. 
     
     
         58 . The method of  claim 52 , wherein the selectively removing the blood components comprises removing free radicals. 
     
     
         59 . The method of  claim 52 , wherein the selectively removing the blood components comprises removing oxygen free radicals. 
     
     
         60 . The method of  claim 52 , wherein the selectively removing the blood components comprises removing heme oxygenase-1. 
     
     
         61 . The method of  claim 52 , wherein passing of the removed blood through the filter comprises passing the removed blood through a therapeutic device comprising the filter, and wherein the circuit connects the device and the subject. 
     
     
         62 . The method of  claim 70 , wherein passing of the removed blood through the filter comprises passing the removed blood through the therapeutic device, wherein the therapeutic device displays information on a screen. 
     
     
         63 . The method of  claim 71 , wherein the therapeutic device comprises a wherein passing of the removed blood through the filter comprises passing the removed blood through the therapeutic device, wherein the therapeutic device displays information on a touch screen. 
     
     
         64 . The method of  claim 52 , wherein the moving of the blood comprises using at least one pump for pumping the blood. 
     
     
         65 . The method of  claim 52 , comprising, prior to the removing of the blood from the subject, inducing therapeutic hypothermia of the subject. 
     
     
         66 . The method of  claim 52 , comprising inducing therapeutic hypothermia of the subject by returning cooled blood to the subject. 
     
     
         67 . The method of  claim 52 , comprising using a blood temperature regulator in inducing therapeutic hypothermia of the subject by returning cooled blood to the subject. 
     
     
         68 . The method of  claim 52 , comprising selectively removing the blood components comprising at least one of soluble or secreted blood components. 
     
     
         69 . The method of  claim 68 , comprising the passing of the removed blood through the filter, wherein the filter comprises a hydrogel layer to which one or more molecules capable of binding one or more of the blood components has been immobilized. 
     
     
         70 . The method of  claim 68 , comprising the passing of the removed blood through the filter, wherein the filter comprises a base and one or more conical cylinders with a larger opening of the one or more conical cylinders oriented away from the base. 
     
     
         71 . The method of  claim 68 , wherein a therapeutic device comprises the filter, and wherein the therapeutic device exerts a centrifugal force on the blood within the one or more conical cylinders, thereby sending the blood into or through the one or more conical cylinders along a spiral path such that the soluble or the secreted blood components, or a portion thereof, are selectively retained in the one or more conical cylinders. 
     
     
         72 . The method of  claim 46 , wherein the passing of the removed blood from the first portion of the circuit through the filter at the blood flow rate of 4-24 L per hour comprises passing the removed blood from the first portion of the circuit through the filter at a blood flow rate of 4-4.5 L per hour. 
     
     
         73 . The method of  claim 46 , wherein the passing of the removed blood from the first portion of the circuit through the filter at the blood flow rate of 4-24 L per hour comprises passing the removed blood from the first portion of the circuit through the filter at a blood flow rate of 4-5 L per hour. 
     
     
         74 . The method of  claim 46 , wherein the passing of the removed blood from the first portion of the circuit through the filter at the blood flow rate of 4-24 L per hour comprises passing the removed blood from the first portion of the circuit through the filter at a blood flow rate of 4-10 L per hour. 
     
     
         75 . The method of  claim 46 , wherein the method is used to treat or prevent post-resuscitation syndrome (PRS). 
     
     
         76 . The method of  claim 46 , comprising adjusting flow rate through the filter based on information about a nature or amount of one or more soluble or secreted blood components in the blood. 
     
     
         77 . The method of  claim 46 , comprising adjusting flow rate through the filter based at least in part on information about a nature or amount of one or more soluble or secreted blood components to be filtered in 30 minute intervals. 
     
     
         78 . The method of  claim 46 , comprising using pressure-driven automatic flow control in adjusting flow rate through the filter to maintain one or more soluble or secreted blood components in the blood below a toxicity threshold. 
     
     
         79 . The method of  claim 46 , comprising detecting IL-6 and adjusting flow rate through the filter to maintain IL-6 below a toxicity threshold.