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Cytokine Adsorption in Severe Acute Respiratory Failure Requiring Veno-Venous Extracorporeal Membrane Oxygenation
- 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.
- Subjects :
- Adult
Male
Resuscitation
ARDS
medicine.medical_treatment
Biomedical Engineering
Biophysics
Bioengineering
030204 cardiovascular system & hematology
Proinflammatory cytokine
Biomaterials
03 medical and health sciences
0302 clinical medicine
Extracorporeal Membrane Oxygenation
medicine
Extracorporeal membrane oxygenation
Humans
Acute respiratory failure
In patient
Respiratory system
Respiratory Distress Syndrome
business.industry
General Medicine
Middle Aged
medicine.disease
surgical procedures, operative
Cytokine
030228 respiratory system
Anesthesia
Cytokines
Female
Adsorption
business
Subjects
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