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10.1016/j.jcrc.2020.07.001

http://scihub22266oqcxt.onion/10.1016/j.jcrc.2020.07.001
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32763058!9629267!32763058
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suck abstract from ncbi


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pmid32763058      J+Crit+Care 2020 ; 60 (ä): 328-333
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  • Therapeutic plasma exchange in adult critically ill patients with life-threatening SARS-CoV-2 disease: A pilot study #MMPMID32763058
  • Faqihi F; Alharthy A; Alodat M; Kutsogiannis DJ; Brindley PG; Karakitsos D
  • J Crit Care 2020[Dec]; 60 (ä): 328-333 PMID32763058show ga
  • PURPOSE: We investigated the effect of therapeutic plasma exchange (TPE) on life-threatening COVID-19; presenting as acute respiratory distress syndrome (ARDS) plus multi-system organ failure and cytokine release syndrome (CRS). MATERIALS AND METHODS: We prospectively enrolled ten consecutive adult intensive care unit (ICU) subjects [7 males; median age: 51 interquartile range (IQR): 45.1-55.9 years old] with life-threatening COVID-19 infection. All had ARDS [PaO2/FiO2 ratio: 110 (IQR): 95.5-135.5], septic shock, CRS and deteriorated within 24 h of ICU admission despite fluid resuscitation, antibiotics, hydroxychloroquine, ARDS-net and prone position mechanical ventilation. All received 5-7 TPE sessions (dosed as 1.0 to 1.5 plasma volumes). RESULTS: All of the following significantly normalized (p < 0.05) following the TPE completion, when compared to baseline: Sequential Organ Function Assessment score, PaO2/FiO2 ratio, levels of lymphocytes, total bilirubin, lactate dehydrogenase, ferritin, C-reactive protein and interleukin-6. No adverse effects from TPE were observed. Acute kidney injury and pulmonary embolism were observed in 10% and 20% of patients, respectively. The duration of mechanical ventilation was 9 (IQR: 7 to 12) days, the ICU length of stay was 15 (IQR: 13.2 to 19.6) days and the mortality on day-28 was 10%. CONCLUSION: TPE demonstrates a potential survival benefit and low risk in life-threatening COVID-19, albeit in a small pilot study.
  • |Adult[MESH]
  • |Aged[MESH]
  • |Bilirubin/blood[MESH]
  • |C-Reactive Protein/analysis[MESH]
  • |COVID-19/complications/*therapy[MESH]
  • |Critical Care[MESH]
  • |Critical Illness/*therapy[MESH]
  • |Female[MESH]
  • |Ferritins/blood[MESH]
  • |Humans[MESH]
  • |Intensive Care Units[MESH]
  • |Interleukin-6/blood[MESH]
  • |L-Lactate Dehydrogenase/blood[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Multiple Organ Failure/therapy[MESH]
  • |Patient Positioning[MESH]
  • |Pilot Projects[MESH]
  • |Plasma Exchange/*methods[MESH]
  • |Prone Position[MESH]
  • |Prospective Studies[MESH]
  • |Respiration, Artificial[MESH]
  • |Respiratory Distress Syndrome/complications/*therapy[MESH]


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