Cytokine adsorption in patients with severe COVID-19 pneumonia requiring extracorporeal membrane oxygenation: protocol for a randomised, controlled, open-label intervention, multicentre trial
| Autor: | Fabian Schubach, Christoph Bode, Daniel Duerschmied, Tobias Wengenmayer, Dawid L. Staudacher, Caroline von Spee-Mayer, Alexander Supady, Marina Rieder, Claudia Schmoor, Jonathan Rilinger |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
ARDS Time Factors Coronavirus disease 2019 (COVID-19) medicine.medical_treatment lcsh:Medicine Severity of Illness Index Extracorporeal 03 medical and health sciences 0302 clinical medicine Extracorporeal Membrane Oxygenation Intervention (counseling) Germany Severity of illness Extracorporeal membrane oxygenation Medicine respiratory medicine (see thoracic medicine) Humans Multicenter Studies as Topic 030212 general & internal medicine adult intensive & critical care Randomized Controlled Trials as Topic business.industry Interleukin-6 lcsh:R Intensive Care COVID-19 General Medicine medicine.disease Pneumonia Cytokine Treatment Outcome 030228 respiratory system Emergency medicine Cytokines business |
| Zdroj: | BMJ Open BMJ Open, Vol 11, Iss 1 (2021) |
| ISSN: | 2044-6055 |
| Popis: | IntroductionVeno-venous extracorporeal membrane oxygenation (V-V ECMO) is a last resort treatment option in patients with severe COVID-19 related acute respiratory distress syndrome (ARDS). Mortality in these critically ill patients is high. Elevated interleukin-6 (IL-6) levels in these severe courses are associated with poor outcome. Extracorporeal cytokine adsorption is an approach to lower elevated IL-6 levels. However, there is no randomised controlled data on the efficacy of cytokine adsorption and its effect on patient outcome in severe COVID-19 related ARDS requiring V-V ECMO support.Methods and analysisWe here report the protocol of a 1:1 randomised, controlled, parallel group, open-label intervention, superiority multicentre trial to evaluate the effect of extracorporeal cytokine adsorption using the CytoSorb device in severe COVID-19 related ARDS treated with V-V ECMO. We hypothesise that extracorporeal cytokine adsorption in these patients is effectively reducing IL-6 levels by 75% or more after 72 hours as compared with the baseline measurement and also reducing time to successful V-V ECMO explantation. We plan to include a total of 80 patients at nine centres in Germany.Ethics and disseminationThe protocol of this study was approved by the ethical committee of the University of Freiburg as the leading institution (EK 285/20). Additional votes will be obtained at all participating centres.Trial registration numbersNCT04385771 and DRKS 00021248. |
| Databáze: | OpenAIRE |
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