Spontaneous tension hemothorax in a severe COVID-19 patient receiving ECMO therapy: The other side of COVID-19-associated coagulopathy

Thammavaranucupt, Kanin; Tassaneyasin, Tanapat; Theerawit, Pongdhep; Sutherasan, Yuda; Pinsem, Pimwatana; Suppadungsuk, Supawadee; Nanthatanti, Nithita; Kirdlarp, Suppachok; Sungkanuparph, Somnuek; Srichatrapimuk, Sirawat

doi:10.1016/j.rmcr.2022.101663

Cited by 2 publications

(1 citation statement)

References 12 publications

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“…Of these, 22 were excluded due to their focus on veno-arterial ECMO (V-A ECMO) or extracorporeal cardiopulmonary resuscitation (ECPR) [ 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. Fourteen studies were excluded for lack or scarcity of data on CytoSorb© use [ 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 ], four because of the lack of specific data for the ECMO subgroup [ 67 , 68 , 69 , 70 ], four because CytoSorb© was not used concomitantly with ECMO therapy [ 71 , 72 , 73 , 74 ], two because outcomes of interest for the simultaneous use of CytoSorb© and ECMO were not reported [ 75 , 76 ], and one because it focused on a different device [ 77 ]. One study was excluded because it only reported preliminary findings from other articles [ 78 ].…”

Section: Resultsmentioning

confidence: 99%

Use of CytoSorb© Hemoadsorption in Patients on Veno-Venous ECMO Support for Severe Acute Respiratory Distress Syndrome: A Systematic Review

Akil¹,

Napp

Rao

et al. 2022

JCM

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Acute respiratory distress syndrome (ARDS) is associated with high morbidity and mortality. Adjunct hemoadsorption is increasingly utilized to target underlying hyperinflammation derived from ARDS. This article aims to review available data on the use of CytoSorb© therapy in combination with V-V ECMO in severe ARDS, and to assess the effects on inflammatory, laboratory and clinical parameters, as well as on patient outcomes. A systematic literature review was conducted and reported in compliance with principles derived from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. When applicable, a before-and-after analysis for relevant biomarkers and clinical parameters was carried out. CytoSorb© use was associated with significant reductions in circulating levels of C-reactive protein and interleukin-6 (p = 0.039 and p = 0.049, respectively). Increases in PaO2/FiO2 reached significance as well (p = 0.028), while norepinephrine dosage reductions showed a non-significant trend (p = 0.067). Mortality rates in CytoSorb© patients tended to be lower than those of control groups of most included studies, which, however, were characterized by high heterogeneity and low power. In an exploratory analysis on 90-day mortality in COVID-19 patients supported with V-V ECMO, the therapy was associated with a significantly reduced risk of death. Based on the reviewed data, CytoSorb© therapy is able to reduce inflammation and potentially improves survival in ARDS patients treated with V-V ECMO. Early initiation of CytoSorb© in conjunction with ECMO might offer a new approach to enhance lung rest and promote recovery in patients with severe ARDS.

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