Continuous Hemofiltration in Hyperthermic Septic Shock Patients

Pestaña, David; Casanova, Elena; Villagrán, María J.; Tormo, Carolina; Pérez‐Chrzanowska, Hanna; Redondo, Javier Rivera; Caldera, María V.; Royo, C.

doi:10.1097/ta.0b013e31802b9575

Cited by 9 publications

(5 citation statements)

References 31 publications

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“…7 Hemofiltration was reported to decrease the temperature and the mortality of patients with hyperthermic septic shock. 8 Continuous hemofiltration could more effectively remove various inflammatory factors of patients with infection complicated by acute renal failure. In addition, continuous hemofiltration could remove IL-6 from the blood stream efficiently in a rat sepsis model.…”

Section: Discussionmentioning

confidence: 99%

Hemofiltration Successfully Eliminates Severe Cytokine Release Syndrome Following CD19 CAR-T-Cell Therapy

Liu¹,

Chen²,

Wang³

et al. 2018

Journal of Immunotherapy

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Cytokine release syndrome (CRS) remains to be a major adverse effect of chimeric antigen receptor T (CAR-T) cell therapy in B-cell acute lymphoblastic leukemia (B-ALL) and lymphoma. It was urgent to explore novel strategy for managing severe CRS. We conducted a clinical trial to assess the safety and efficacy of CD19-targeting CAR-T-cells in the treatment of relapsed and chemotherapy-refractory B-ALL and lymphoma. A 10-year-old boy with B-ALL who never achieved minimal residual disease (MRD) negative status after 5 courses of chemotherapy was enrolled into our study and received a total of 3.19×106/kg autologous CD19 CAR-T-cells. Before CAR-T-cell infusion, naive lymphocytes made up 41.8% of bone marrow cells, which were reduced to 1% at the 14th day after transfusion, with MRD<10−4. However, this patient developed grade 4 CRS, multiple organ failure, hemophagocytic syndrome, neurotoxicity, and severe pulmonary infection after CAR-T-cell therapy. Tocilizumab and glucocorticoids treatment were ineffective for controlling the adverse effects and in contrast, hemofiltration immediately ameliorated the severe CRS and prevented the exacerbation of multiple organ dysfunction, pneumonia, and hydrosarca caused by CAR-T-cell therapy. All side effects disappeared within days following hemofiltration. Hemofiltration helped quickly clear cytokines, speeded up patient recover, and successfully resolved the severe CRS crisis. This was the first report, reporting the successful use of hemofiltration to eliminate adverse reactions of CAR-T-cell therapy.

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Section: Discussionmentioning

confidence: 99%

Hemofiltration Successfully Eliminates Severe Cytokine Release Syndrome Following CD19 CAR-T-Cell Therapy

Liu¹,

Chen²,

Wang³

et al. 2018

Journal of Immunotherapy

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“…The larger range of fever definitions in the observational studies may have contributed (along with other factors such as variations in study design, patient population, and analysis techniques) to the greater heterogeneity observed in the meta-analysis results. Of note, the observational study with the highest threshold for fever treatment (39.5°C) demonstrated the most substantial improvement in 28-day/hospital mortality with antipyretic therapy (44). The implication of this finding is unclear, though, because of this study’s small sample size, methodologic limitations, and unique method of physical cooling (continuous venovenous hemofiltration).…”

Section: Discussionmentioning

confidence: 99%

Antipyretic Therapy in Critically Ill Septic Patients: A Systematic Review and Meta-Analysis

Drewry

Ablordeppey

Murray

et al. 2017

Critical Care Medicine

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“…These findings may explain the hyperpyrexia of our patient. The use of haemofiltration for thermoregulation has been well described in the literature, especially in hyperpyrexial septic patients, unresponsive to antipyretics 17 , while extracorporeal circuits are being adapted more for other clinical needs such as thermoregulation 18 .…”

Section: Discussionmentioning

confidence: 99%

Haemophilus Influenzae Associated Guillain Barre Syndrome with Thrombocytopenic Purpura and Hyperthermia

Condon

Tobin

2008

Anaesth Intensive Care

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A 24-year-old female who had been intubated for respiratory distress was transferred to our intensive care unit, where a subsequent diagnosis of Guillain Barré Syndrome was made. Her only positive culture was Haemophilus influenzae from sputum. Despite having a severe form of the disease, with autonomic dysfunction and hyperthermia, she made a far better, more rapid recovery than expected. We review the evidence that patients with Haemophilus influenzae associated Guillain Barré Syndrome recover more quickly than those with other causative agents. We also discuss the implications of thrombocytopenia in these patients and the management of hyperthermia in an intensive care unit setting.

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Continuous Hemofiltration in Hyperthermic Septic Shock Patients

Abstract: Continuous low-flow hemofiltration decreased body temperature and vasopressor requirements in hyperthermic septic shock patients. The mortality was unexpectedly low.

Cited by 9 publications

References 31 publications

Hemofiltration Successfully Eliminates Severe Cytokine Release Syndrome Following CD19 CAR-T-Cell Therapy

Hemofiltration Successfully Eliminates Severe Cytokine Release Syndrome Following CD19 CAR-T-Cell Therapy

Antipyretic Therapy in Critically Ill Septic Patients: A Systematic Review and Meta-Analysis

Haemophilus Influenzae Associated Guillain Barre Syndrome with Thrombocytopenic Purpura and Hyperthermia

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