| Autor: |
Porosnicu TM; Center for Complex Network Science 'V.Babes', University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania., Gindac C; Intensive Care Unit 'Pius Branzeu', Emergency Clinical County Hospital, Liviu Rebreanu 156, 300723 Timisoara, Romania., Popovici S; Intensive Care Unit 'Pius Branzeu', Emergency Clinical County Hospital, Liviu Rebreanu 156, 300723 Timisoara, Romania., Marinescu A; Discipline of Infectious Diseases, Department XIII, 'V.Babes' University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania., Jipa D; Intensive Care Unit 'Pius Branzeu', Emergency Clinical County Hospital, Liviu Rebreanu 156, 300723 Timisoara, Romania., Lazaroiu V; Clinical Hospital of Infectious Diseases and Pneumo Phtisiology 'Doctor V.Babes', Gh.Adam 13 Street, 300310 Timisoara, Romania., Sandesc D; Department of Anaesthesia and Intensive Care 'V.Babes' University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania., Oancea C; Center for Research and Innovation in Personalized Respiratory Disease Medicine, 'V.Babes' University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania., Folescu R; Department of Balneology, Medical Recovery and Rheumatology, Family Medicine Discipline, Center for Preventive Medicine for Advanced Research in Cardiovascular Pathology and Hemostaseology, 'V.Babes' University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania., Zamfir AS; Department of Internal Medicine III, Discipline of Pneumology, 'Grigore T. Popa' University of Medicine and Pharmacy, 16 University Str., 700115 Iasi, Romania., Zamfir CL; Department of Morpho-Functional Sciences I, 'Grigore T. Popa' University of Medicine and Pharmacy, 16 University Str., 700115 Iasi, Romania., Nussbaum LA; Department of Neurosciences, 'V.Babes' University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania., Sirbu IO; Center for Complex Network Science 'V.Babes', University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania. |
| Abstrakt: |
Background and Objectives: The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has surprised the medical world with its devastating effects such as severe acute respiratory distress syndrome (ARDS) and cytokine storm, but also with the scant therapeutic solutions which have proven to be effective against the disease. Therapeutic plasma exchange (TPE) has been proposed from the very beginning as a possible adjuvant treatment in severe cases. Our objective was to analyze the evolution of specific biological markers of the COVID-19 disease before and one day after a therapeutic plasma exchange session, how a change in these parameters influences the patient’s respiratory status, as well as the impact of TPE on the survival rate. Materials and Methods: In this retrospective study, we include 65 patients with COVID-19 admitted to the intensive care unit department of our hospital between March 2020 and December 2021, and who received a total of 120 sessions of TPE. Results: TPE significantly reduced the following inflammation markers (p < 0.001): interleukin-6 (IL-6), C-reactive protein (CRP), lactate dehydrogenase (LDH), fibrinogen, ferritin, and erythrocyte sedimentation rate. This procedure significantly increased the number of lymphocytes and decreased D-dimers levels (p = 0.0024). TPE significantly improved the PaO2/FiO2 ratio (p < 0.001) in patients with severe acute respiratory distress syndrome (PaO2/FiO2 < 100). Survival was improved in intubated patients who received TPE. Conclusions: TPE involved the reduction in inflammatory markers in critical patients with COVID-19 disease and the improvement of the PaO2/FiO2 ratio in patients with severe ARDS and had a potential benefit on the survival of patients with extremely severe COVID-19 disease. |
