Extracorporeal Blood Purification and Organ Support in the Critically Ill Patient during COVID-19 Pandemic: Expert Review and Recommendation: Blood Purification

C. Ronco, S.M. Bagshaw, R. Bellomo, W.R. Clark, F. Husain-Syed, J.A. Kellum, Z. Ricci, T. Rimmelé, T. Reis, M. Ostermann

Research output: Contribution to journalArticlepeer-review

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 languageEnglish
Pages (from-to)17-27
Number of pages11
JournalBlood Purif.
Volume50
Issue number1
DOIs
Publication statusPublished - 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

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