Blood purification in sepsis and COVID-19 : what's new in cytokine and endotoxin hemoadsorption
Ruiz-Rodriguez, Juan Carlos (Universitat Autònoma de Barcelona. Departament de Medicina)
Plata-Menchaca, Erika P. (Vall d'Hebron Institut de Recerca (VHIR))
Chiscano-Camón, Luis (Universitat Autònoma de Barcelona. Departament de Medicina)
Ruiz-Sanmartin, Adolf (Universitat Autònoma de Barcelona. Departament de Medicina)
Ferrer, Ricard (Universitat Autònoma de Barcelona. Departament de Medicina)

Data:	2022
Resum:	Sepsis and COVID-19 are two clinical conditions that can lead to a dysregulated inflammatory state causing multiorgan dysfunction, hypercytokinemia, and a high risk of death. Specific subgroups of critically ill patients with particular characteristics could benefit from rescue treatment with hemoadsorption. There is a lack of adequately designed randomized controlled trials evaluating the potential benefits of cytokine or endotoxin hemoadsorption. Critically ill COVID-19 patients with severe acute respiratory failure poorly responsive to conventional treatment could be candidates to receive cytokine hemoadsorption in the presence of high levels of interleukin 6. This treatment can also be suitable for patients with refractory septic shock and hypercytokinemia. In the context of high endotoxin activity, hemoadsorption with polymyxin B could improve clinical parameters and the prognosis of patients with refractory septic shock. Predictive enrichment, using biomarkers or other individual features, identifies potential responders to cytokine, endotoxin, or sequential hemoadsorption. Besides, recognizing the particular subsets of patients likely to respond to one or both types of hemoadsorption will aid the design of future studies that accurately validate the effectiveness of these therapies.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Acute respiratory distress syndrome ; COVID-19 ; Cytokine hemoadsorption ; Cytosorb ; Endotoxin Hemoperfusion ; Hypercytokinemia ; Polymyxin B ; SARS-CoV-2 pneumonia ; Sepsis
Publicat a:	Journal of Anesthesia, Analgesia and Critical Care, Vol. 2 (april 2022) , ISSN 2731-3786

DOI: 10.1186/s44158-022-00043-w
PMID: 37386575

10 p, 885.1 KB

El registre apareix a les col·leccions:
Articles > Articles de recerca
Articles > Articles publicats