Consenso colombiano de expertos sobre recomendaciones informadas en la evidencia para la prevención, diagnóstico y manejo de la lesión renal aguda por SARS-CoV-2/COVID-19

González, Camilo; Yama, Erika; Yomayusa, Nancy; Vargas, Juan Guillermo; Rico, Jorge Cruz; Ariza, Amaury; Aroca, Gustavo; Baquero, Richard; Ramírez, Roberto; Chacón, Kelly; Torres, Rodolfo; Robayo, Adriana; Peña, Adalberto; Meza, Adriana; Molano, Alejandra; Caicedo, Andrea; Acevedo, Andrés; Calderón, Angélica; Zambrano, Betty; Musso, Carlos Guido; Lozano, Carlos Daniel Grasa; Buitrago, Cristóbal; Ballesteros, David; Chacón, Diana; Vargas, Diana; Gayón, Diana; Villafañe, Douglas; López, Francisco Pérez; Ardila, Freddy; Pinzón, Guillermo; Guerrero, Gustavo; Benavides, Helman; Villanueva, Ignacio; Raoch, Ingrid; Galeano, Javier; Gordon, Jennifer; Cáceres, Jimena; Pulido, Jorge Calvo; Pérez, Jorge; Contreras, Kateir; Aristizábal, Leidy; Valderrama, Luis Alfonso; Gómez, María de Lourdes Martínez; Vargas, María José Bueno; Carrascal, Martha; Rodríguez, M. Rivero; Guerrero, Mauricio; Alfaro, Mercedes; Tobón, Natalia; García, P. Solís; Rodríguez, P J Suárez-Anta; Daza, Rodrigo; Espitaleta, Zilac

doi:10.22265/acnef.7.supl.2.473

Cited by 11 publications

(19 citation statements)

References 36 publications

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“…Global mortality in our patients was 36.9%, similar to other studies such as Hirsch et al, were the mortality was 34.8% [8]. It is worth to highlight that the mortality was lower in patients with CKD than in patients without CKD.…”

Section: Discussionsupporting

confidence: 89%

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Acute kidney injury in Colombian patients with COVID-19 who received kidney support therapy with genius® 90 technology

Rey-Vela¹,

Muñoz²,

Rico-Fontalvo³

et al. 2020

J Clini Nephrol

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Introduction: Acute kidney injury (AKI) is one of the complications associated with severe COVID-19 infection, and it can present in up to 20% to 40% of the cases; of these, approximately 20% will require renal replacement therapy (RRT). Objective: To establish clinical and laboratory characteristics in a group of patients from Colombia with COVID-19 infection and AKI that received intermittent and prolonged RRT with the GENIUS ® 90 technology in between March and July 2020. Design: Cross-sectional study. Results: 78.9% of participants were men and 21.1% were women. The main comorbidities were the following: Hypertension (65.3%), diabetes mellitus (38.9%), obesity (26.3%), cancer (5.3%), Chronic obstructive pulmonary disease (11.6%), cardiovascular disease (23.2%), active smoking (11.6%). 33.7% had chronic kidney disease (CKD) in the average serum creatinine on admission was 4.4 mg/dl. The following infl ammatory markers were elevated: C-reactive protein (CRP), d-dimer and ferritin (20.3 mg/dl, 931mcg/l and 1174 ng/ml, respectively). 63.5% of patients underwent sustained low-effi ciency dialysis (SLED) (6 to 12 hours) and the rest of the patients (36.35%) underwent conventional hemodialysis (less than 4 hours). The mortality of the total patient sample was 36.9%, lower in patients with CKD than in patients with no previous renal disease history (18.7% and 40.1%, respectively). Conclusion: Renal complications are frequent in patients with severe COVID-19. The development of AKI could be an isolated prognostic marker associated with an increase in mortality in patients with COVID-19, and one of the options is intermittent and prolonged RRT with the GENIUS ® 90 system. Acute kidney injury in Colombian patients with COVID-19 who received kidney support therapy with genius ® 90 technology

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Section: Discussionsupporting

confidence: 89%

“…AKI is common in patients with COVID-19, being present in approximately 20 to 40% of the patients admitted to the ICU. Of these, 20% require RRT during the course [3,8].…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury in Colombian patients with COVID-19 who received kidney support therapy with genius® 90 technology

Rey-Vela¹,

Muñoz²,

Rico-Fontalvo³

et al. 2020

J Clini Nephrol

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“…En el consenso colombiano para la prevención, diagnóstico y manejo de la lesión renal aguda por SARS-CoV-2, se genera el siguiente interrogante: ¿Cuáles terapias extracorpóreas para aclaramiento de citoquinas disponible en Colombia podrían tener beneficio como parte del manejo de la tormenta de citoquinas asociada a COVID 19? ; y se describen distintas modalidades de terapia extracorpórea orientadas a eliminar los factores inflamatorios, lograr estabilización hemodinámica, reducción de lactato y prevenir daño de órganos en pacientes con enfermedad severa; que incluyen: hemoperfusión directa usando un sorbente neutro-macroporoso, adsorción de plasma en una resina después de la separación del plasma de la sangre completa, TRRC con filtros de fibra hueca con propiedades de adsorción, TRRC de dosis alta con membranas de corte medio o corte alto, la terapia de recambio plasmático y la plasmaféresis 53 .…”

Section: Plasmaferesis Y Terapia De Recambio Plasmatico Como Nuevo Blanco Terapeutico En Covid-19unclassified

“…Algunos expertos sugieren dosis de tratamiento entre 1.5 y 2 veces el volumen plasmático del paciente con duraciones entre dos y cuatro horas, usando tasas de flujo sanguíneo al inicio de entre 50 y 80 ml/min y aumentando gradualmente hasta 100 o 150 ml/min 43 . La plasmaféresis, parece ser útil en COVID-19 debido a la afinidad entre la envoltura viral y las lectinas, sin embargo, esta modalidad requiere mayor investigación 43,53 .…”

Section: Plasmaferesis Y Terapia De Recambio Plasmatico Como Nuevo Blanco Terapeutico En Covid-19unclassified

“…A partir de lo anterior, el consenso no recomienda el uso rutinario de recambio plasmático terapéutico en COVID-19 severa, sin embargo, en centros con alta experiencia, puede ser usado cuidadosamente en casos específicos evaluando riesgo-beneficio y pronóstico individual (Recomendación fuerte a favor) 53 .…”

Section: Plasmaferesis Y Terapia De Recambio Plasmatico Como Nuevo Blanco Terapeutico En Covid-19unclassified

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Plasmaféresis como opción terapéutica en infección por COVID-19

et al. 2020

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Introducción: La COVID-19, es una neumonía ocasionada por el nuevo coronavirus SARS-CoV-2, que se puede presentar con cuadros severos, distrés respiratorio agudo (SDRA), disfunción orgánica múltiple y muerte; como consecuencia de una respuesta inflamatoria alterada denominada “tormenta de citoquinas”. La plasmaféresis se propone como una estrategia de tratamiento prometedora para el manejo de este tipo de complicaciones. Objetivo: nuestro objetivo principal es mostrar toda la bibliografía disponible, referente a la utilidad de la plasmaféresis en el manejo de la tormenta de citoquinas en pacientes con COVID-19 grave; evaluar su posible beneficio y proponer realizar nuevos ensayos clínicos que avalen el uso rutinario de esta terapia. Metodología: se realizó una búsqueda avanzada con los términos DeSC “Infecciones por Coronavirus; SARS-CoV; Plasmaféresis; Recambio plasmático; Disfunción orgánica múltiple; Sepsis; Síndrome de respuesta inflamatoria sistémica; Lesión renal aguda”. A través de los motores de búsqueda Clinical Key, Embase, PubMed y Ovid, obteniendo un total de 156 resultados, entre artículos originales, reportes de casos, series de casos y revisiones de la literatura, se seleccionaron un total de 54 artículos que fueron utilizados para la elaboración de la presente revisión de la literatura. Conclusiones: la terapia de recambio plasmático se podría utilizar como tratamiento complementario, con el objetivo de reducir carga inflamatoria y viral, reduciendo así el daño de órgano blanco. Sin embargo, hace falta la realización de ensayos clínicos controlados y con buenos diseños metodológicos, que nos ayuden a demostrar la efectividad de este tipo de terapias en pacientes con COVID-19 grave.

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The Use of CytoSorb Therapy in Critically Ill COVID-19 Patients: Review of the Rationale and Current Clinical Experiences

Ruiz‐Rodríguez

Molnár

Deliargyris

et al. 2021

Critical Care Research and Practice

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The COVID-19 pandemic has led to the biggest global health crisis of our lifetime. There is accumulating evidence that a substantial number of critically ill COVID-19 patients exhibit a dysregulated host response manifesting as cytokine storm or cytokine release syndrome, which in turn contributes to the high observed rates of mortality. Just as in other hyperinflammatory conditions, extracorporeal cytokine removal may have potential beneficial effects in this subgroup of COVID-19 patients. The CytoSorb blood purification device is the most extensively investigated cytokine removal platform with considerable evidence suggesting that early intervention can provide rapid hemodynamic stabilization and improvement in vital organ functions. The purpose of this review is to provide an overview of the pathophysiological background of hyperinflammation in COVID-19 and to summarize the currently available evidence on the effects of hemoadsorption in these patients.

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Consenso colombiano de expertos sobre recomendaciones informadas en la evidencia para la prevención, diagnóstico y manejo de la lesión renal aguda por SARS-CoV-2/COVID-19

Cited by 11 publications

References 36 publications

Acute kidney injury in Colombian patients with COVID-19 who received kidney support therapy with genius® 90 technology

Acute kidney injury in Colombian patients with COVID-19 who received kidney support therapy with genius® 90 technology

Plasmaféresis como opción terapéutica en infección por COVID-19

The Use of CytoSorb Therapy in Critically Ill COVID-19 Patients: Review of the Rationale and Current Clinical Experiences

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