Abstract
Critically ill COVID-19 patients are generally admitted to the ICU for respiratory insufficiency which can evolve into a multiple-organ dysfunction syndrome requiring extracorporeal organ support. Ongoing advances in technology and science and progress in information technology support the development of integrated multi-organ support platforms for personalized treatment according to the changing needs of the patient. Based on pathophysiological derangements observed in COVID-19 patients, a rationale emerges for sequential extracorporeal therapies designed to remove inflammatory mediators and support different organ systems. In the absence of vaccines or direct therapy for COVID-19, extracorporeal therapies could represent an option to prevent organ failure and improve survival. The enormous demand in care for COVID-19 patients requires an immediate response from the scientific community. Thus, a detailed review of the available technology is provided by experts followed by a series of recommendation based on current experience and opinions, while waiting for generation of robust evidence from trials. © 2020 S. Karger AG, Basel. Copyright: All rights reserved.
Original language | English |
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Pages (from-to) | 17-27 |
Number of pages | 11 |
Journal | Blood Purif. |
Volume | 50 |
Issue number | 1 |
DOIs | |
Publication status | Published - 2021 |
Keywords
- Continuous renal replacement therapies
- Cytokine removal
- Extracorporeal organ support
- Hemoadsorption
- Hemoperfusion
- cytokine
- eculizumab
- ferritin
- interleukin 1beta
- interleukin 6
- low molecular weight heparin
- noradrenalin
- tumor necrosis factor
- vaccine
- acute kidney failure
- acute lung injury
- acute respiratory failure
- artificial ventilation
- cardiopulmonary bypass
- continuous renal replacement therapy
- coronavirus disease 2019
- critically ill patient
- cytokine release
- electrolyte blood level
- extracorporeal circulation
- extracorporeal oxygenation
- hemadsorption
- hemoperfusion
- human
- hypercapnia
- hypercoagulability
- hypertension
- hypoxia
- immune dysregulation
- immune response
- immunosuppressive treatment
- intensive care unit
- lung gas exchange
- mean arterial pressure
- metabolic acidosis
- multiple organ failure
- pandemic
- phagocytosis
- plasma exchange
- randomized controlled trial (topic)
- resuscitation
- Review
- Sequential Organ Failure Assessment Score
- thrombophilia
- tidal volume
- blood
- complication
- critical illness
- devices
- equipment design
- isolation and purification
- procedures
- Continuous Renal Replacement Therapy
- COVID-19
- Critical Illness
- Cytokines
- Equipment Design
- Extracorporeal Membrane Oxygenation
- Humans
- Multiple Organ Failure