Care Bundles to Improve Hemoperfusion Performance in Patients with Severe COVID-19: A Retrospective Study DOI Open Access
Sirirat Mueankwan, Konlawij Trongtrakul, Pattraporn Tajarernmuang

et al.

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(12), P. 3360 - 3360

Published: June 7, 2024

Background/Objectives: Hemoperfusion (HP) is employed to modulate cytokine storms in severe coronavirus disease 2019 (COVID-19) patients, requiring careful attention for success and safety. Therefore, we investigated whether our care bundles could enhance HP performance. Methods: We conducted a retrospective cohort study on adult patients (≥20 years old) with COVID-19 pneumonia. In the first wave (Phase I), identified HP-related issues addressed them second II). The included early temperature control, precise hemodynamic monitoring, clot prevention measures membrane. rate associated adverse events (AEs) were assessed between two phases. Results: 60 (HA330) sessions from 27 cases I: 21 9 cases; Phase II: 39 18 cases). Patient characteristics treatments similar, except baseline body (BT) heart (HR). II showed higher (67% vs. 89%, p = 0.19), although it did not reach statistical significance. I recorded significantly frequency of AEs (3 [IQR 1, 4] events/case 1 0, 2] events/case, 0.014). After implementing bundles, hypothermia decreased (78% 33%, 0.037), an adjusted odds ratio 0.15; 95% CI 0.02–0.95, 0.044 BT. Conclusions: Further exploration larger sample size required establish advantages bundles. However, bundles’ implementation has improved prevention.

Language: Английский

Use of extracorporeal blood purification therapies in sepsis: the current paradigm, available evidence, and future perspectives DOI Creative Commons
Gabriella Bottari, V. Marco Ranieri, Can İnce

et al.

Critical Care, Journal Year: 2024, Volume and Issue: 28(1)

Published: Dec. 25, 2024

Sepsis is the result of a dysregulated immune response to infection and associated with acute organ dysfunction. The syndrome's complexity contingent upon underlying pathology individual patient characteristics, including their response. involvement multiple organs physiological functions adds complexity, "organ cross-talk" emerging as pivotal pathophysiological clinical aspect. This narrative review evaluate rationale available evidence supporting use extracorporeal blood purification therapies adjunctive therapy in patients sepsis septic shock. A search PubMed, Embase, Web Science Scopus databases for relevant literature from August 2002 May 2024 has been conducted. was performed using terms: 1) "blood purification" or "hemadsorption" "plasma exchange" AND 2) "sepsis" "septic shock". Therefore authors have focused our discussion on several key areas such conducting well-designed trials, developing more personalized protocols, ensuring optimal management monitoring. Given heterogeneity sepsis, traditional randomized trials this domain can be daunting task. However, statistical techniques Bayesian methods, propensity score analysis, emulated hold promise enhancing comparability between study groups. Indeed, comprehend efficacy it imperative assemble homogeneous groups receiving uniform treatments. Clinical strategies should individualized, signaling end "one size fits all" approach need Current suggested best practice cytokine hemadsorption sepsis.

Language: Английский

Citations

5
Efficacy of hemoadsorption in the severe course of COVID-19 DOI Creative Commons
A. Yu. Yakovlev,

Y. V. Ilyin,

Feodor Feodorovitch Bershadsky

et al.

Frontiers in Medicine, Journal Year: 2025, Volume and Issue: 12

Published: March 6, 2025

Insufficiencies of the majority targeted therapies for most severe, life-threatening forms COVID-19 warrant alternative, adjuvant treatment options enhanced life maintenance that include extracorporeal blood purification and homeostasis support. The goal current study is to evaluate clinical efficacy hemoadsorption with mesoporous hypercrosslinked polystyrene beads (Efferon CT single-use cartridge) in an expanded cohort patients severe critical resistant antibody requiring post-therapy invasive mechanical lung ventilation (MLV) versus parameter-matched control group no hemoadsorption. A single-center (NCT06402279) enrolled from October 2020 February 2022: Efferon (non-responders anti-cytokine therapy IMV, hemadsorption, standard treatment, n = 65) retrospectively acquired propensity-matched (no only, 65). This observational revealed capability safely, rapidly, significantly reduce need norepinephrine, increase oxygenation index, prevent sepsis-associated AKI, decrease development multiorgan failure, restore immune system balance by decreasing pro-inflammatory IL-6, ferritin levels, neutrophil-to-lymphocyte ratio. efficiency using was confirmed resolution acute respiratory failure 54% patients, increasing number days without early index oxygenation. Most importantly, safe resulted a significant mortality patients. www.clinicaltrials.gov, Identifier NCT06402279.

Language: Английский

Citations

0
Lesson learnt from implementing a CRRT reimbursement program in a resource-limited setting DOI
Prit Kusirisin,

Sadudee Peerapornratana,

Jiratorn Sutawong

et al.

Journal of Critical Care, Journal Year: 2025, Volume and Issue: 88, P. 155089 - 155089

Published: April 16, 2025

Language: Английский

Citations

0
Care Bundles to Improve Hemoperfusion Performance in Patients with Severe COVID-19: A Retrospective Study DOI Open Access
Sirirat Mueankwan, Konlawij Trongtrakul, Pattraporn Tajarernmuang

et al.

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(12), P. 3360 - 3360

Published: June 7, 2024

Background/Objectives: Hemoperfusion (HP) is employed to modulate cytokine storms in severe coronavirus disease 2019 (COVID-19) patients, requiring careful attention for success and safety. Therefore, we investigated whether our care bundles could enhance HP performance. Methods: We conducted a retrospective cohort study on adult patients (≥20 years old) with COVID-19 pneumonia. In the first wave (Phase I), identified HP-related issues addressed them second II). The included early temperature control, precise hemodynamic monitoring, clot prevention measures membrane. rate associated adverse events (AEs) were assessed between two phases. Results: 60 (HA330) sessions from 27 cases I: 21 9 cases; Phase II: 39 18 cases). Patient characteristics treatments similar, except baseline body (BT) heart (HR). II showed higher (67% vs. 89%, p = 0.19), although it did not reach statistical significance. I recorded significantly frequency of AEs (3 [IQR 1, 4] events/case 1 0, 2] events/case, 0.014). After implementing bundles, hypothermia decreased (78% 33%, 0.037), an adjusted odds ratio 0.15; 95% CI 0.02–0.95, 0.044 BT. Conclusions: Further exploration larger sample size required establish advantages bundles. However, bundles’ implementation has improved prevention.

Language: Английский

Citations

0