Honore Patrick M, Redant Sebastien, Datzmann Thomas
ICU Department, Brugmann University Hospital, Centre Hospitalier Universitaire Brugmann, Place Van Gehuchtenplein, 4, 1020, Brussels, Belgium.
Universitätsklinik Ulm, Ulm, Germany.
Intensive Care Med Exp. 2020 Jul 29;8(1):38. doi: 10.1186/s40635-020-00333-z.
3,4-Methylenedioxymethamphetamine intoxication can result in potentially lethal multi-organ failure, for which the current treatment is largely supportive. Recently, a report of the use of the CytoSorb device as a part of the successful treatment of a patient with 3,4-methylenedioxymethamphetamine intoxication and multi-organ failure has been described.
While 3,4-methylenedioxymethamphetamine was very effectively removed by CytoSorb in vitro, the degree of removal in the clinical setting described may have been minimal. Indeed, the therapy was started relatively late in this case, and, as the therapy is concentration dependent, the removal of 3,4-methylenedioxymethamphetamine is likely to have been limited. On the other hand, in this case, CytoSorb hemoadsorption was very effective to treat rhabdomyolysis and hyperinflammation.
The in vitro experimentation demonstrates that 3,4-methylenedioxymethamphetamine is effectively removed by CytoSorb. However, it is debatable whether the case report confirms the possibility of in vivo removal of 3,4-methylenedioxymethamphetamine by CytoSorb. Nevertheless, the potential of the CytoSorb device to contribute to the treatment of many critically ill patients has yet to be fully explored, and further studies are warranted.
3,4-亚甲基二氧甲基苯丙胺中毒可导致潜在致命的多器官功能衰竭，目前对此的治疗主要是支持性的。最近，有报告描述了使用CytoSorb装置成功治疗一名3,4-亚甲基二氧甲基苯丙胺中毒并伴有多器官功能衰竭患者的情况。
虽然3,4-亚甲基二氧甲基苯丙胺在体外被CytoSorb非常有效地清除，但在所述临床环境中的清除程度可能极小。实际上，在该病例中治疗开始相对较晚，而且由于该治疗是浓度依赖性的，3,4-亚甲基二氧甲基苯丙胺的清除可能受到限制。另一方面，在该病例中，CytoSorb血液吸附对治疗横纹肌溶解和过度炎症非常有效。
体外实验表明CytoSorb能有效清除3,4-亚甲基二氧甲基苯丙胺。然而，该病例报告是否证实了CytoSorb在体内清除3,4-亚甲基二氧甲基苯丙胺的可能性仍存在争议。尽管如此，CytoSorb装置对许多危重病患者治疗的潜在作用尚未得到充分探索，有必要进行进一步研究。
