Hemoadsorption for management of patients on veno-venous ECMO support for severe COVID-19 acute respiratory distress syndrome
© 2021 Wiley Periodicals LLC..
BACKGROUND AND AIM: Patients with severe coronavirus disease 2019 (COVID-19) develop a profound cytokine-mediated pro-inflammatory response. This study reports outcomes in 10 patients with COVID-19 supported on veno-venous extracorporeal membrane oxygenation (VV-ECMO) who were selected for the emergency use of a hemoadsorption column integrated in the ECMO circuit.
MATERIALS AND METHODS: Pre and posttreatment, clinical data, and inflammatory markers were assessed to determine the safety and feasibility of using this system and to evaluate the clinical effect.
RESULTS: During hemoadsorption, median levels of interleukin (IL)-2R, IL-6, and IL-10 decreased by 54%, 86%, and 64%, respectively. Reductions in other markers were observed for lactate dehydrogenase (-49%), ferritin (-46%), d-dimer (-7%), C-reactive protein (-55%), procalcitonin (-76%), and lactate (-44%). Vasoactive-inotrope scores decreased significantly over the treatment interval (-80%). The median hospital length of stay was 53 days (36-85) and at 90-days post cannulation, survival was 90% which was similar to a group of patients without the use of hemoadsorption.
CONCLUSIONS: Addition of hemoadsorption to VV-ECMO in patients with severe COVID-19 is feasible and reduces measured cytokine levels. However, in this small series, the precise impact on the overall clinical course and survival benefit still remains unknown.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:36 |
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| Enthalten in: |
Journal of cardiac surgery - 36(2021), 11 vom: 30. Nov., Seite 4256-4264 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Geraci, Travis C [VerfasserIn] |
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| Links: |
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| Themen: |
Cardiovascular pathology |
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| Anmerkungen: |
Date Completed 04.10.2021 Date Revised 05.10.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/jocs.15785 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM327659319 |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021 Wiley Periodicals LLC. | ||
| 520 | |a BACKGROUND AND AIM: Patients with severe coronavirus disease 2019 (COVID-19) develop a profound cytokine-mediated pro-inflammatory response. This study reports outcomes in 10 patients with COVID-19 supported on veno-venous extracorporeal membrane oxygenation (VV-ECMO) who were selected for the emergency use of a hemoadsorption column integrated in the ECMO circuit | ||
| 520 | |a MATERIALS AND METHODS: Pre and posttreatment, clinical data, and inflammatory markers were assessed to determine the safety and feasibility of using this system and to evaluate the clinical effect | ||
| 520 | |a RESULTS: During hemoadsorption, median levels of interleukin (IL)-2R, IL-6, and IL-10 decreased by 54%, 86%, and 64%, respectively. Reductions in other markers were observed for lactate dehydrogenase (-49%), ferritin (-46%), d-dimer (-7%), C-reactive protein (-55%), procalcitonin (-76%), and lactate (-44%). Vasoactive-inotrope scores decreased significantly over the treatment interval (-80%). The median hospital length of stay was 53 days (36-85) and at 90-days post cannulation, survival was 90% which was similar to a group of patients without the use of hemoadsorption | ||
| 520 | |a CONCLUSIONS: Addition of hemoadsorption to VV-ECMO in patients with severe COVID-19 is feasible and reduces measured cytokine levels. However, in this small series, the precise impact on the overall clinical course and survival benefit still remains unknown | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a cardiovascular pathology | |
| 650 | 4 | |a cardiovascular research | |
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| 700 | 1 | |a Kon, Zachary N |e verfasserin |4 aut | |
| 700 | 1 | |a Moazami, Nader |e verfasserin |4 aut | |
| 700 | 1 | |a Chang, Stephanie H |e verfasserin |4 aut | |
| 700 | 1 | |a Carillo, Julius |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Stacey |e verfasserin |4 aut | |
| 700 | 1 | |a Fargnoli, Anthony |e verfasserin |4 aut | |
| 700 | 1 | |a Alimi, Marjan |e verfasserin |4 aut | |
| 700 | 1 | |a Pass, Harvey |e verfasserin |4 aut | |
| 700 | 1 | |a Galloway, Aubrey |e verfasserin |4 aut | |
| 700 | 1 | |a Smith, Deane E |e verfasserin |4 aut | |
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