Abstract: FR-PO1005
Simultaneous Triple Membrane Extracorporeal Therapy: A Success Case in Guadalajara, Mexico
Session Information
- Hemodialysis: Clinical Challenges, Patient-Centered Outcomes, and Quality of Life
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Marmolejo Bedolla, Hector Manuel, Hospital San Javier, Guadalajara, Jal., Mexico
- Chirinos Gómez, Omar, Hospital San Javier, Guadalajara, Jal., Mexico
- Guiza, Samuel G., Hospital San Javier, Guadalajara, Jal., Mexico
- Macías, Lucio Octavio Sánchez, Hospital San Javier, Guadalajara, Jal., Mexico
Introduction
Multi-Organ Support Therapy (MOST) aims to integrate extracorporeal technologies into a unified therapeutic platform. The following presents the first successful case in Mexico involving the use of simultaneous triple extracorporeal membranes.
Case Description
39-year-old man with KDIGO G5D, who received a kidney transplant in 2021. Admitted for Pneumocystis jirovecii-pneumonia.
He presented respiratory deterioration to acute hypoxemic respiratory failure, requiring mechanical ventilation; with refractory hypercapnia and progressive respiratory acidosis.
Given the persistent anuria, hyperphosphatemia and refractory respiratory failure, it was decided to initiate simultaneous extracorporeal support. This multimodal strategy incorporated continuous venovenous hemodiafiltration (CVVHDF), hemoadsorption membrane and extracorporeal carbon dioxide removal (ECCO2R). Once triple support was started, a sustained reduction in PaCO2 levels was documented, with normalization of pH, stabilization of acid-base balance and C Reactive Protein control with de-escalation of ventilatory settings.
Discussion
This strategy made it possible to break the positive feedback loops between lungs, kidneys, and systemic inflammation. Facilitating ultra-protective ventilation. HDFVVC achieves the removal of medium-molecular-weight solutes and precise management of fluid balance.
The cytokine enviroment is a key driver of hemodynamic collapse in sepsis; hemadsorption cartridge is designed to capture most pro-inflammatory cytokines; thereby modulating the immune response to reduce the need for vasopressors to stabilize hemodynamics and lower mortality. ECCO2R is the critical differentiating factor, as it allows for extracorporeal CO2 removal at relatively low blood flow rates, facilitating ultra-protective ventilation strategies and the normalization of hypercapnia.
Acknowledgment
Special thank to Doctor Lucio than gave us a lot of information, education and the time to do this presentation. This achivement wont been possible without him.