Extracorporeal membrane oxygenation and cytokine adsorption

Datzmann, Thomas; Träger, Karl

doi:10.21037/jtd.2017.10.128

Cited by 67 publications

(73 citation statements)

References 42 publications

(62 reference statements)

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“…Consequently, considerable research efforts have focused on alternative strategies aimed at non-specific sequestration of inflammatory mediators; for example, blood purification through filtration, dialysis (diffusion) and adsorption [139][140][141][142].…”

Section: Covid-19 For Avenues Therapeuticmentioning

confidence: 99%

Cytokine storm and COVID-19: a chronicle of pro-inflammatory cytokines

et al. 2020

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Coronavirus disease 2019 (COVID-19) has swept the world, unlike any other pandemic in the last 50 years. Our understanding of the disease has evolved rapidly since the outbreak; disease prognosis is influenced mainly by multi-organ involvement. Acute respiratory distress syndrome, heart failure, renal failure, liver damage, shock and multi-organ failure are strongly associated with morbidity and mortality. The COVID-19 disease pathology is plausibly linked to the hyperinflammatory response of the body characterized by pathological cytokine levels. The term ‘cytokine storm syndrome’ is perhaps one of the critical hallmarks of COVID-19 disease severity. In this review, we highlight prominent cytokine families and their potential role in COVID-19, the type I and II interferons, tumour necrosis factor and members of the Interleukin family. We address various changes in cellular components of the immune response corroborating with changes in cytokine levels while discussing cytokine sources and biological functions. Finally, we discuss in brief potential therapies attempting to modulate the cytokine storm.

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Section: Covid-19 For Avenues Therapeuticmentioning

confidence: 99%

Cytokine storm and COVID-19: a chronicle of pro-inflammatory cytokines

et al. 2020

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“…In this scenario, hemoadsorption therapy may be used to decrease cytokine levels in case of excessive inflammatory response and due to its unspecific adsorptive characteristics also substances like myoglobin, free hemoglobin, or bilirubin. Trager et al [34] report successful treatment of septic shock and a severe SIRS response with pronounced hypercytokinemia with a combination of cytokine reduction and inflammation reduction with CytoSorb, VA-ECMO, renal support with continuous renal replacement therapy (CRRT) and low-dose hydrocortisone [35]. It seems that controlling pro-inflammatory response may be advantageous for the maintenance of the vascular barrier function, which plays a pivotal role in the development of tissue edema and oxygen mismatch.…”

Section: Cytokine Stormmentioning

confidence: 99%

COVID-19 and ECMO: the interplay between coagulation and inflammation—a narrative review

et al. 2020

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Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has presently become a rapidly spreading and devastating global pandemic. Veno-venous extracorporeal membrane oxygenation (V-V ECMO) may serve as life-saving rescue therapy for refractory respiratory failure in the setting of acute respiratory compromise such as that induced by SARS-CoV-2. While still little is known on the true efficacy of ECMO in this setting, the natural resemblance of seasonal influenza's characteristics with respect to acute onset, initial symptoms, and some complications prompt to ECMO implantation in most severe, pulmonary decompensated patients. The present review summarizes the evidence on ECMO management of severe ARDS in light of recent COVID-19 pandemic, at the same time focusing on differences and similarities between SARS-CoV-2 and ECMO in terms of hematological and inflammatory interplay when these two settings merge.

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“…Fluid overload appears to be the commonest indication for RRT in patients with ARDS on VV-ECMO [113,114]. Mediator removal during extracorporeal circuit treatment to reduce biotrauma has been proposed, although evidence is lacking [115,116].…”

Section: Rationalementioning

confidence: 99%

Lung–kidney interactions in critically ill patients: consensus report of the Acute Disease Quality Initiative (ADQI) 21 Workgroup

et al. 2019

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Background: Multi-organ dysfunction in critical illness is common and frequently involves the lungs and kidneys, often requiring organ support such as invasive mechanical ventilation (IMV), renal replacement therapy (RRT) and/or extracorporeal membrane oxygenation (ECMO). Methods:A consensus conference on the spectrum of lung-kidney interactions in critical illness was held under the auspices of the Acute Disease Quality Initiative (ADQI) in Innsbruck, Austria, in June 2018. Through review and critical appraisal of the available evidence, the current state of research, and both clinical and research recommendations were described on the following topics: epidemiology, pathophysiology and strategies to mitigate pulmonary dysfunction among patients with acute kidney injury and/or kidney dysfunction among patients with acute respiratory failure/acute respiratory distress syndrome. Furthermore, emphasis was put on patients receiving organ support (RRT, IMV and/or ECMO) and its impact on lung and kidney function. Conclusion:The ADQI 21 conference found significant knowledge gaps about organ crosstalk between lung and kidney and its relevance for critically ill patients. Lung protective ventilation, conservative fluid management and early recognition and treatment of pulmonary infections were the only clinical recommendations with higher quality of evidence. Recommendations for research were formulated, targeting lung-kidney interactions to improve care processes and outcomes in critical illness.

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Extracorporeal membrane oxygenation and cytokine adsorption

Cited by 67 publications

References 42 publications

Cytokine storm and COVID-19: a chronicle of pro-inflammatory cytokines

Cytokine storm and COVID-19: a chronicle of pro-inflammatory cytokines

COVID-19 and ECMO: the interplay between coagulation and inflammation—a narrative review

Lung–kidney interactions in critically ill patients: consensus report of the Acute Disease Quality Initiative (ADQI) 21 Workgroup

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