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

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.

• Authors: Claudio Ronco, Sean M Bagshaw, Rinaldo Bellomo, William R Clark, Faeq Husain-Syed, John A Kellum, Zaccaria Ricci, Thomas Rimmelé, Thiago Reis, Marlies Ostermann
• Journal: Blood purification (Blood Purif) 2021 Vol. 50 Issue 1 Pg. 17-27 ISSN: 1421-9735 [Electronic] Switzerland
• PMID: 32454500 (Publication Type: Journal Article, Review)
• Copyright: © 2020 S. Karger AG, Basel.

Chemical References

• Cytokines

Topics

• COVID-19 (blood, complications, therapy)
• Continuous Renal Replacement Therapy (instrumentation, methods)
• Critical Illness (epidemiology, therapy)
• Cytokines (blood, isolation & purification)
• Equipment Design
• Extracorporeal Membrane Oxygenation (instrumentation, methods)
• Hemoperfusion (instrumentation, methods)
• Humans
• Multiple Organ Failure (blood, etiology, therapy)