Hemoadsorption for management of Patients on Veno-venous ECMO Support for Severe COVID-19 Acute Respiratory Distress Syndrome
| Autor: | Stephanie H. Chang, Stacey Chen, Julius A. Carillo, Aubrey C. Galloway, Marjan Alimi, Anthony S. Fargnoli, Nader Moazami, Travis C. Geraci, Zachary N. Kon, Harvey I. Pass, Deane E. Smith |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
Coronavirus disease 2019 (COVID-19) medicine.medical_treatment cardiovascular pathology Acute respiratory distress cardiovascular research perfusion Procalcitonin Catheterization chemistry.chemical_compound Extracorporeal Membrane Oxygenation Lactate dehydrogenase Extracorporeal membrane oxygenation Humans Medicine Respiratory Distress Syndrome biology SARS-CoV-2 business.industry COVID-19 Interleukin Original Articles Ferritin chemistry Anesthesia biology.protein Original Article Surgery Cardiology and Cardiovascular Medicine business Perfusion |
| Zdroj: | Journal of Cardiac Surgery |
| Popis: | Background and aim of the study: 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 post treatment, 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 LDH (-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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|