Link to article: Cytokine adsorption in
patients with severe COVID-19 pneumonia requiring extracorporeal membrane
oxygenation
by Marina Rieder, Tobias Wengenmayer, Dawid Staudacher,
Daniel Duerschmied and Alexander Supady
The treatment of patients with severe COVID-19 requiring
support with veno-venous extracorporeal membrane oxygenation (vv-ECMO) is
particularly challenging from a medical point of view and consumes a tremendous
amount of human, physical, and financial resources. Recommendations for
initiation of vv-ECMO in COVID-19 are being developed, though under continuous
review [1, 2]. However, despite all therapeutic
efforts, these critically ill patients have a high mortality rate according to
studies published so far [3, 4].
At our hospital, a major referral center for extracorporeal
support, we have treated several COVID-19 patients with vv-ECMO. Knowing
interleukin-6 (IL-6) as a predictor of negative outcome, some patients received
cytokine adsorption using the CytoSorb® adsorber (CytoSorbents Europe, Berlin,
Germany) shortly after initiation of ECMO for up to 72 h [5]. Based on experience in septic patients,
the adsorber was exchanged every 24 h [6]. Integration of the adsorber in the ECMO
circuit was feasible and safe. Preliminary data from eight cases (4 patients
receiving ECMO with cytokine adsorption, the remaining 4 received ECMO without
cytokine adsorption) shows that cytokine adsorption may result in a more
pronounced decrease of IL-6 after initiation of ECMO (Fig. 1)…
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