The absorbing filter Oxiris in severe coronavirus disease 2019 patients: A case series

Zhang, Hongtao; Zhu, Guizhen; Liang, Yan; Lü, Yang; Fang, Qiying; Shao, Fengmin

doi:10.1111/aor.13786

Cited by 36 publications

(41 citation statements)

References 18 publications

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“…A recent case series showed improvement in COVID-19 patients’ haemodynamics and organ function following CRRT with oXiris filter. 7 Another study also demonstrated the safety of CRRT with oXiris filter in COVID-19 patients with reduction in CRP, IL-6 and PCT levels. However, there is still insufficient evidence on the optimum timing and indication for initiation of CRRT with oXiris filter in order to achieve the best outcome.…”

Section: Discussionmentioning

confidence: 92%

Use of extracorporeal blood purification therapy (ECBPT) as an adjuvant to high-dose corticosteroids in a severely ill COVID-19 patient with concomitant bacterial infection

2021

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COVID-19 presents with a spectrum of severity, ranging from asymptomatic or mild symptoms to those with acute respiratory distress syndrome. Corticosteroids are widely used for their efficacy in reducing inflammatory responses. However, its use may be limited to patients with immunosuppression. An adjunct therapy for cytokine storm in COVID-19 is extracorporeal blood purification therapies using high adsorptive filters, such as oXiris, to remove cytokines. We share our experience in using continuous renal replacement therapy with oXiris haemofilter as a temporising measure to high-dose corticosteroids in managing cytokine storm in a deteriorating COVID-19 patient with concomitant bacterial infection.

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Section: Discussionmentioning

confidence: 92%

Use of extracorporeal blood purification therapy (ECBPT) as an adjuvant to high-dose corticosteroids in a severely ill COVID-19 patient with concomitant bacterial infection

2021

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“…We and others have explored the use of cytokine blood purification in an attempt to prevent, control, or reduce (suspected) hyperinflammation [ 27 , 28 , 29 , 30 , 31 ]. Several blood purification devices are currently on the market, showing a significant reduction of pro-inflammatory cytokines and restore homoeostatic dysregulation associated with systemic inflammatory syndromes [ 32 , 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal Blood Purification in Moderate and Severe COVID-19 Patients: A Prospective Cohort Study

et al. 2021

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Introduction: Coronavirus disease 2019 (COVID-19) is characterized by hyperinflammation and coagulopathy. Severe cases often develop respiratory distress, requiring mechanical ventilation and with critical cases progressing to acute respiratory distress syndrome. Control of hyperinflammation has been proposed as a possible therapeutic avenue for COVID-19; extracorporeal blood purification (EBP) modalities offer an attractive mean to ameliorate maladaptive inflammation. With this work, we evaluated the longitudinal changes of systemic inflammatory markers in critically ill COVID-19 patients treated with blood purification using AN69ST (oXiris®) haemofilter. Methods: We performed a time-series analysis of 44 consecutive COVID-19 cases treated with the AN69ST (oXiris®) cytokine adsorbing haemofilter (CAH) according to local practice; we visualize longitudinal results of biochemical, inflammatory, blood gas, and vital sign parameters focussing on systemic levels of interleukin-6 (IL-6), C-reactive protein (CRP), and procalcitonin. Results: All patients were treated with ≥1 cycle extracorporeal continuous venovenous haemofiltration (CVVH) with CAH; of these, 30 severe patients received CVVH-CAH within 4–12 h of admission after recognizing a hyper-inflammatory state. Another 14 patients admitted with mild-to-moderate symptoms progressed to severe disease and were placed on EBP during hospitalization. The treatment was associated with a reduction of ferritin, CRP, fibrinogen, several inflammatory markers, and a resolution of numerous cytopenias. The observed mortality across the cohort was 36.3%. Conclusion: EBP with CAH was associated with a decrease in CRP, and control of IL-6 and procalcitonin.

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“…We observed 19 cases (43.2%) ( We and others have explored the use of cytokine blood purification in an attempt to prevent, control or reduce (suspected) hyperinflammation [26][27][28][29][30]. Several blood-purification devices are currently on the market, showing a significant reduction of pro-inflammatory cytokines and restore homeostatic dysregulation associated with systemic inflammatory syndromes [31][32][33].…”

Section: Time-series Analyses Of Inflammatory Biomarkers Vital Signsmentioning

confidence: 99%

Extracorporeal Blood Purification in moderate and severe COVID-19 patients: a prospective cohort study

Rosalia

Ugurov

Neziri

et al. 2020

Preprint

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Introduction: COVID-19 is characterised by hyperinflammation and coagulopathy. Severe cases often develop respiratory distress, requiring mechanical ventilation and critical cases progressing to ARDS. Control of hyperinflammation has been proposed as a possible therapeutic avenue for COVID-19; extracorporeal blood purification (EBP) modalities offer an attractive mean to ameliorate maladaptive inflammation. With this work, we describe the longitudinal variation of parameters of systemic inflammation in critically ill COVID-19 patients treated with blood purification using AN69ST (oXiris) hemodiafilter. Methods: We performed a time-series analysis of 44 consecutive COVID-19 cases treated with the AN69ST (oXiris) cytokine adsorbing hemodiafilter; we visualise longitudinal results of biochemical, inflammatory, blood gas- and vital sign parameters. Results: Blood purification was indicated for suspected hyperinflammation or hypercoagulation, (= CRP > 100 mg/L and/or IL-6 > 40 pg/mL and/or Ferritin > 500 ng/mL and/or Lactate Dehydrogenase > 365 U/L or D-dimers > 2000 ng/mL). All patients were treated with at least 1 cycle extracorporeal continuous venovenous hemofiltration (CVVHF) with cytokine adsorbing hemodiafilter (CAH); of these, 30 severe patients received CVVHF-CAH within 4 - 12 hours of hospitalisation. Another 14 patients admitted with mild-to-moderate symptoms progressed to severe disease and placed on EBP during the course of hospitalisation. The treatment was associated with a reduction of Ferritin, C-reactive protein, Fibrinogen, several inflammatory markers and a resolution of numerous cytopenias. The observed mortality across the cohort was 36.3% across the cohort. Conclusion: Extracorporeal blood purification with cytokine adsorbing hemofilter was associated with a decrease in the acute phase proteins CRP, Ferritin, and resolution of numerous cytopenias. Repetitive hemofiltration has been associated with lower levels of IL-6 in COVID-19 patients.

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The absorbing filter Oxiris in severe coronavirus disease 2019 patients: A case series

Cited by 36 publications

References 18 publications

Use of extracorporeal blood purification therapy (ECBPT) as an adjuvant to high-dose corticosteroids in a severely ill COVID-19 patient with concomitant bacterial infection

Use of extracorporeal blood purification therapy (ECBPT) as an adjuvant to high-dose corticosteroids in a severely ill COVID-19 patient with concomitant bacterial infection

Extracorporeal Blood Purification in Moderate and Severe COVID-19 Patients: A Prospective Cohort Study

Extracorporeal Blood Purification in moderate and severe COVID-19 patients: a prospective cohort study

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