Department of Nephrology, University of Padova, Padova, Italy.
International Renal Research Institute (IRRIV), San Bortolo Hospital, Vicenza, Italy.
Blood Purif. 2021;50(1):17-27. doi: 10.1159/000508125. Epub 2020 May 26.
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.
危重症 COVID-19 患者通常因呼吸功能不全而被收入 ICU，如果病情进展则可能出现需要体外器官支持的多器官功能障碍综合征。技术和科学的持续进步以及信息技术的进步支持了根据患者不断变化的需求开发个性化治疗的综合多器官支持平台。基于在 COVID-19 患者中观察到的病理生理紊乱，出现了一种合理的观点，即采用序贯体外治疗方法，以清除炎症介质并支持不同的器官系统。在没有 COVID-19 疫苗或直接治疗方法的情况下，体外治疗方法可能是预防器官衰竭和提高生存率的一种选择。COVID-19 患者的大量护理需求需要科学界立即做出反应。因此，专家提供了对现有技术的详细审查，然后根据当前的经验和观点提出了一系列建议，同时等待试验产生强有力的证据。
