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Cytokine Adsorption in Severe Acute Respiratory Failure Requiring Veno-Venous Extracorporeal Membrane Oxygenation

Authors :
Corinna N. Lang
Paul Biever
Marina Rieder
Christoph Benk
Tobias Wengenmayer
Achim Lother
Christoph Bode
Alexander Supady
Daniel Duerschmied
Dawid L. Staudacher
Timm Zahn
Source :
ASAIO journal (American Society for Artificial Internal Organs : 1992). 67(3)
Publication Year :
2021

Abstract

Veno-venous extracorporeal membrane oxygenation (V-V ECMO) is a last resort treatment option for patients with acute respiratory failure (acute respiratory distress syndrome [ARDS]). Cytokine adsorption has been incorporated in the management of some of these patients on an individual basis to control the imbalance of danger-associated molecular patterns and proinflammatory cytokines. However, little is known about the combination of V-V ECMO and cytokine adsorption as earlier reports contained mixed patient cohorts in terms of disease and mode of ECMO, veno-venous and veno-arterial. We here report single-center registry data of nine all-comers with severe ARDS treated with V-V ECMO and cytokine adsorption using the CytoSorb adsorber compared with a control group of nine propensity score matched patients undergoing V-V ECMO support without cytokine adsorption. Even though Respiratory ECMO Survival Prediction and PRedicting dEath for SEvere ARDS on V-V ECMO scores predicted a higher mortality in the cytokine adsorption group, mortality was numerically reduced in the patients undergoing V-V ECMO and cytokine removal compared with V-V ECMO alone. The need for fluid resuscitation and vasopressor support as well as lactate levels dropped significantly in the cytokine adsorption group within 72 hours, whereas vasopressor need and lactate levels did not decrease significantly in the control group. Therefore, our data suggest that cytokine adsorption might be beneficial in patients with severe ARDS requiring V-V ECMO support.

Details

ISSN :
1538943X
Volume :
67
Issue :
3
Database :
OpenAIRE
Journal :
ASAIO journal (American Society for Artificial Internal Organs : 1992)
Accession number :
edsair.doi.dedup.....97450331fb6039a78361f0a2b1fdbf5b