Evaluation of Clinical and Machine Data of Critically Ill Adult COVID Patients with Acute Kidney Injury Exposed to Enhanced Hemoadsorption during CRRT DOI Open Access
Augusto Cama-Olivares, Victor Ortiz-Soriano, Lucas J. Liu

et al.

Blood Purification, Journal Year: 2023, Volume and Issue: 53(6), P. 476 - 485

Published: Dec. 16, 2023

<b><i>Introduction:</i></b> The FDA authorized the emergency use of enhanced hemoadsorption with oXiris in critically ill adult COVID patients respiratory failure or severe disease to reduce inflammation. In this study, we evaluated acute kidney injury (AKI) who were exposed versus not during continuous renal replacement therapy (CRRT). <b><i>Methods:</i></b> Retrospective cohort study AKI requiring CRRT. Exposure was defined as receiving for &gt;12 cumulative hours and more than one-third time within first 72 h Study outcomes included filter-specific performance metrics clinical such ventilator requirement, mortality, dialysis dependence. Inverse probability treatment weighting used balance potential confounders weighted regression models. <b><i>Results:</i></b> 14,043 CRRT corresponding 85 analyzed. Among these, 2,736 corresponded exposure (<i>n</i> = 25 patients) 11,307 a standard filter 60 patients). Transmembrane pressures (TMPs) increased rapidly overall higher filter, but life (median 36.3 vs. 33.1 h, <i>p</i> 0.913, respectively) filter/clotting alarms remained similar both groups. adjusted models, independently associated composite hospital mortality dependence at discharge (OR 2.13, 95% CI: 0.98–4.82, 0.06), it fewer (β −15.02, −29.23 −0.82, 0.04) intensive care unit days −14.74, −28.54 −0.95, survivors. <b><i>Discussion/Conclusion:</i></b> CRRT, filters exhibited levels TMP when compared no differences alarm profiles observed. improvement discharge.

Language: Английский

COVID-19 and Acute Kidney Injury DOI
James Hilton, Naomi Boyer, Mitra K. Nadim

et al.

Critical Care Clinics, Journal Year: 2022, Volume and Issue: 38(3), P. 473 - 489

Published: Jan. 10, 2022

Language: Английский

Citations

49
Continuous renal replacement therapy in combination with oXiris haemofilter in a paediatric patient with sodium valproate-induced acute pancreatitis DOI
Ying Wang, Yang Gao, Lin Zhao

et al.

BMJ Case Reports, Journal Year: 2025, Volume and Issue: 18(2), P. e258126 - e258126

Published: Feb. 1, 2025

Some clinical trials have validated a new perspective on continuous renal replacement therapy (CRRT) in combination with oXiris haemofilter to more effectively enhance endotoxins clearance and circulating cytokines adsorption, stabilise vital signs, correct haemodynamic disorders accelerate the recovery of organ function, thus providing survival benefits. However, no such mode has been reported paediatric patients sodium valproate (SV)-induced acute pancreatitis (AP). An early childhood boy was admitted department critical care medicine, due sudden upper abdominal pain lasting for 2 days. The child had 2-year history epilepsy took 120 mg SV two times per day than months, after which he diagnosed first episode AP, bronchopneumonia paroxysmal supraventricular tachycardia. culprit AP identified as SV. After admission intensive unit, immediately stopped taking received comprehensive treatment followed by CRRT haemofilter. On 3rd admission, nasojejunal tube implanted, enteral nutrition, probiotics levetiracetam. 22nd discharged from hospital. At 3-month follow-up discharge, returned normal life without any sequelae. To best our knowledge, this is case SV-induced patient who achieved complete undergoing haemofilter, suggesting that could be safely applied similar pathogenesis mechanisms adjuvant therapy.

Language: Английский

Citations

1
Extracorporeal blood purification strategies in sepsis and septic shock: An insight into recent advancements DOI Open Access
Yatin Mehta, Rajib Paul,

Abdul Samad Ansari

et al.

World Journal of Critical Care Medicine, Journal Year: 2023, Volume and Issue: 12(2), P. 71 - 88

Published: March 7, 2023

Despite various therapies to treat sepsis, it is one of the leading causes mortality in intensive care unit patients globally. Knowledge about pathophysiology sepsis has sparked interest extracorporeal (ECT) which are intended balance dysregulation immune system by removing excessive levels inflammatory mediators.To review recent data on use ECT and assess their effects clinical outcomes.In this review, an extensive English literature search was conducted from last two decades identify sepsis. A total 68 articles peer-reviewed indexed journals were selected excluding publications with only abstracts.Results showed that techniques such as high-volume hemofiltration, coupled plasma adsorption/filtration, resin or polymer adsorbers, CytoSorb® emerging adjunct improve hemodynamic stability most published regard field septic shock reports improved survival rates lowered sequential organ failure assessment scores, lactate levels, leucocyte count, platelet interleukin- IL-6, IL-10, TNF levels.Clinical acceptance currently still limited due a lack large random trials. In addition patient-tailored therapies, future research developments targeting cellular level response expected.

Language: Английский

Citations

18
Effect of Continuous Renal Replacement Therapy with the oXiris Hemofilter on Critically Ill Patients: A Narrative Review DOI Open Access
Yupei Li,

Peiyan Sun,

Kaixi Chang

et al.

Journal of Clinical Medicine, Journal Year: 2022, Volume and Issue: 11(22), P. 6719 - 6719

Published: Nov. 13, 2022

Critically ill patients with sepsis and severe COVID-19 are commonly characterized by a dysregulated immune response an acute kidney injury. Continuous renal replacement therapy (CRRT) is now proposed as promising adjuvant to treat these critically removing cytokines, pathogen-associated molecular patterns, damage-associated patterns from the blood. Although multiple hemofilters, including high-cutoff membranes, oXiris hemofilter, CytoSorb hemoadsorption device, Toraymyxin hemoperfusion cartridge, have been used in current clinical practice, use of hemofilter particular interest because it only kind that can provide therapy, remove endotoxins, adsorb cytokines simultaneously. During past five years, growing body literature has shown CRRT improve hemodynamics organ function decrease endotoxins both septic patients. Here, we performed narrative review describe development history discuss therapeutic effect oXiris-CRRT on searching PubMed, Web Science, clinicaltrials.gov databases for articles published inception 8 September 2022 (updated 1 November) English language restriction. We also summarized knowledge anticoagulation techniques safety concerns when delivering sessions.

Language: Английский

Citations

25
Extracorporeal haemoadsorption: does the evidence support its routine use in critical care? DOI Open Access
Alexander Supady, Daniel Brodie, Tobias Wengenmayer

et al.

The Lancet Respiratory Medicine, Journal Year: 2021, Volume and Issue: 10(3), P. 307 - 312

Published: Dec. 15, 2021

Language: Английский

Citations

32
Continuous Renal Replacement Therapy With oXiris Filter May Not be an Effective Resolution to Alleviate Cytokine Release Syndrome in Non-AKI Patients With Severe and Critical COVID-19 DOI Creative Commons
Kai Kang, Yunpeng Luo, Yang Gao

et al.

Frontiers in Pharmacology, Journal Year: 2022, Volume and Issue: 13

Published: Feb. 4, 2022

In this study, we aimed to determine whether continuous renal replacement therapy (CRRT) with oXiris filter may alleviate cytokine release syndrome (CRS) in non-AKI patients severe and critical coronavirus disease 2019 (COVID-19). A total of 17 COVID-19 treated between February 14 March 26, 2020 were included randomly divided into intervention group control according the random number table. Patients immediately received CRRT plus conventional treatment, while those only treatment. Demographic data collected collated at admission. During ICU hospitalization, concentrations circulating cytokines inflammatory chemokines, including IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ, quantitatively measured daily reflect degree CRS induced by SARS-CoV-2 infection. Clinical data, severity white blood cell count (WBC), neutrophil proportion (NEUT%), lymphocyte (LYMPH), percentage (LYM%), platelet (PLT), C-reaction protein (CRP), high sensitivity C-reactive (hs-CRP), alanine aminotransferase (ALT), aspartate (AST), bilirubin (TB), albumin (ALB), serum creatinine (SCr), D-Dimer, fibrinogen (FIB), hospital days sequential organ failure assessment (SOFA) score obtained from medical records, then compared two groups. Age, SCr significantly differed Besides IL-2 concentration that was lower on day 2 than 1 group, IL-6 higher 1, similar IL-10 5, there no significant differences To sum up, not effectively COVID-19. Thus, its application these should be considered caution avoid increasing unnecessary burden society individuals making already overwhelmed system even more strained (IRB number: IRB-AF/SC-04).

Language: Английский

Citations

20
Repurposing clinically available drugs and therapies for pathogenic targets to combat SARS‐CoV‐2 DOI Creative Commons

Yiying Xue,

Husheng Mei,

Yisa Chen

et al.

MedComm, Journal Year: 2023, Volume and Issue: 4(3)

Published: May 14, 2023

The coronavirus disease 2019 (COVID-19) pandemic has affected a large portion of the global population, both physically and mentally. Current evidence suggests that rapidly evolving subvariants risk rendering vaccines antibodies ineffective due to their potential evade existing immunity, with enhanced transmission activity higher reinfection rates could lead new outbreaks across globe. goal viral management is disrupt life cycle as well relieve severe symptoms such lung damage, cytokine storm, organ failure. In fight against viruses, combination genome sequencing, elucidation structure proteins, identifying proteins are highly conserved multiple coronaviruses revealed many molecular targets. addition, time- cost-effective repurposing preexisting antiviral drugs or approved/clinical for these targets offers considerable clinical advantages COVID-19 patients. This review provides comprehensive overview various identified pathogenic pathways corresponding repurposed COVID-19. These findings provide insight into discovery novel therapeutic strategies be applied control emanating from SARS-CoV-2 variants.

Language: Английский

Citations

11
Extracorporeal Blood Purification in Moderate and Severe COVID-19 Patients: A Prospective Cohort Study DOI Creative Commons
Rodney Alexander Rosalia, Petar Ugurov,

Dashurie Neziri

et al.

Blood Purification, Journal Year: 2021, Volume and Issue: 51(3), P. 233 - 242

Published: June 14, 2021

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

Language: Английский

Citations

26
Enzyme‐free photothermally amplified fluorescent immunosorbent assay (PAFISA) for sensitive cytokine quantification DOI Creative Commons
Dian Li, Wei He, Xuyan Lin

et al.

Aggregate, Journal Year: 2023, Volume and Issue: 4(6)

Published: July 18, 2023

Abstract Cytokine monitoring has attracted great attention due to its significance in the diagnosis and treatment of many diseases, such as tumors, microbial infections, immunological diseases. Enzyme‐linked immunosorbent assay (ELISA) is one most popular methods cytokine detection, ascribing lavish signal amplification ELISA platform. In addition classical enzymes, other amplifiers fluorescent probes, artificial nano‐enzymes, photothermal reagents have been applied reduce detection limit produce more sensitive kits. Due accumulative effect heat, are promising materials ELISA. However, lack efficient generation material at an aggregate scale may delay further development this area. contribution, based on organic material, enzyme‐free photothermally amplified system consisting microfluidic chip detecting platform was developed. The nanoparticles with highly conversion by harvesting energy via excited‐state intramolecular motions enlarging molar absorptivity were successfully prepared. concentration 50 pg/mL interleukin‐2 achieved, realizing a improvement limits 20‐fold compared that previously reported microscopic imaging integrated plane sweeping technology provided high spatial resolution precision, indicating potential achieving throughput profiling microscale. Moreover, alternative excitation source, light‐emitting diode not only affordable miniaturized but also revealed feasibility motion‐induced photothermy for biological analyses.

Language: Английский

Citations

10
Effect of extracorporeal hemoadsorption in critically ill patients with COVID-19: A narrative review DOI Creative Commons

Kaixi Chang,

Yupei Li, Zheng Qin

et al.

Frontiers in Immunology, Journal Year: 2023, Volume and Issue: 14

Published: Feb. 3, 2023

COVID-19 has been affecting the world unprecedentedly and will remain widely prevalent due to its elusive pathophysiological mechanism continuous emergence of new variants. Critically ill patients with are commonly associated cytokine storm, multiple organ dysfunction, high mortality. To date, growing evidence shown that extracorporeal hemoadsorption can exert adjuvant effect standard care by regulating immune homeostasis, reducing viremia, decreasing endotoxin activity in critically cases. However, selection various hemofilters, timing initiation termination therapy, anticoagulation management circuits, identification target subgroups, ultimate survival benefit controversial. The purpose this narrative review is comprehensively summarize rationale for use gather latest clinical field.

Language: Английский

Citations

6