Use of hemoadsorption in sepsis-associated ECMO-dependent severe ARDS: A case series
Standard
Use of hemoadsorption in sepsis-associated ECMO-dependent severe ARDS: A case series. / Kogelmann, Klaus; Scheller, Morten; Drüner, Matthias; Jarczak, Dominik.
in: J Intensive Care Soc, Jahrgang 21, Nr. 2, 1751143718818992, 05.2020, S. 183-190.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Use of hemoadsorption in sepsis-associated ECMO-dependent severe ARDS: A case series
AU - Kogelmann, Klaus
AU - Scheller, Morten
AU - Drüner, Matthias
AU - Jarczak, Dominik
N1 - © The Intensive Care Society 2018.
PY - 2020/5
Y1 - 2020/5
N2 - Introduction: Acute respiratory distress syndrome in the context of severe sepsis and septic shock represents a serious clinical disorder. A recent case series in patients with septic shock and renal failure receiving hemoadsorption treatment showed rapid hemodynamic stabilization and increased survival, particularly in pneumonia patients and in those where therapy was started early. We hypothesized that patients suffering from pneumonia and refractory acute respiratory distress syndrome to the extent that they required extracorporeal membrane oxygenation support could possibly demonstrate the most pronounced benefit from the treatment.Methods: We assessed the association of hemoadsorption treatment with hemodynamics, ventilation, and outcome variables in a set of patients with septic shock, acute respiratory distress syndrome, need for veno-venous extracorporeal membrane oxygenation, and continuous renal replacement therapy.Results: Key observations include a significant stabilization in hemodynamics as evidenced by a marked decrease in catecholamine need, which was paralleled by a clear reduction in hyperlactatemia. Respiratory variables improved significantly. In addition, severity of illness and overall organ dysfunction showed a considerable decrease during the course of treatment. Observed mortality was approximately half as predicted by APACHE II. Treatment with CytoSorb was safe and well tolerated with no device-related adverse events.Discussion: This is the first case series reporting on outcome variables associated to CytoSorb therapy in critically ill patients with septic shock, acute respiratory distress syndrome, veno-venous extracorporeal membrane oxygenation, and continuous renal replacement therapy. Based on our observations in this small case series, CytoSorb might represent a potentially promising therapy option for patients with refractory extracorporeal membrane oxygenation-dependent acute respiratory distress syndrome in the context of septic shock.
AB - Introduction: Acute respiratory distress syndrome in the context of severe sepsis and septic shock represents a serious clinical disorder. A recent case series in patients with septic shock and renal failure receiving hemoadsorption treatment showed rapid hemodynamic stabilization and increased survival, particularly in pneumonia patients and in those where therapy was started early. We hypothesized that patients suffering from pneumonia and refractory acute respiratory distress syndrome to the extent that they required extracorporeal membrane oxygenation support could possibly demonstrate the most pronounced benefit from the treatment.Methods: We assessed the association of hemoadsorption treatment with hemodynamics, ventilation, and outcome variables in a set of patients with septic shock, acute respiratory distress syndrome, need for veno-venous extracorporeal membrane oxygenation, and continuous renal replacement therapy.Results: Key observations include a significant stabilization in hemodynamics as evidenced by a marked decrease in catecholamine need, which was paralleled by a clear reduction in hyperlactatemia. Respiratory variables improved significantly. In addition, severity of illness and overall organ dysfunction showed a considerable decrease during the course of treatment. Observed mortality was approximately half as predicted by APACHE II. Treatment with CytoSorb was safe and well tolerated with no device-related adverse events.Discussion: This is the first case series reporting on outcome variables associated to CytoSorb therapy in critically ill patients with septic shock, acute respiratory distress syndrome, veno-venous extracorporeal membrane oxygenation, and continuous renal replacement therapy. Based on our observations in this small case series, CytoSorb might represent a potentially promising therapy option for patients with refractory extracorporeal membrane oxygenation-dependent acute respiratory distress syndrome in the context of septic shock.
U2 - 10.1177/1751143718818992
DO - 10.1177/1751143718818992
M3 - SCORING: Journal article
VL - 21
SP - 183
EP - 190
JO - J Intensive Care Soc
JF - J Intensive Care Soc
SN - 1751-1437
IS - 2
M1 - 1751143718818992
ER -