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严重 2019 冠状病毒病患者的吸收性过滤器 Oxiris:一项病例系列研究。

The absorbing filter Oxiris in severe coronavirus disease 2019 patients: A case series.

机构信息

Department of Nephrology, The People's Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

Artif Organs. 2020 Dec;44(12):1296-1302. doi: 10.1111/aor.13786. Epub 2020 Sep 1.

Abstract

Hypercytokines cause acute respiratory distress syndrome (ARDS) in coronavirus disease 2019 (COVID-19) patients, which is the main reason for intensive care unit treatment and the leading cause of death in COVID-19 patients. Cytokine storm is a critical factor in the development of ARDS. This study evaluated the efficacy and safety of Oxiris filter in the treatment of COVID-19 patients. Five patients with COVID-19 who received continuous renal replacement therapy (CRRT) in Henan provincial people's hospital between January 23, 2019 and March 28, 2020, were enrolled in this study. Heart rate (HR), mean arterial pressure (MAP), oxygenation index (PaO /FiO ), renal function, C-reactive protein (CRP), cytokines, procalcitonin (PCT), acute physiology and chronic health evaluation II (APACHE II), sequential organ failure score (SOFA), and prognosis were compared after CRRT. Five COVID-19 patients, three males and two females, aged 70.2 ± 19.6 years, were enrolled. After treatment, HR (101.4 ± 14.08 vs. 83.8 ± 6.22 bpm/min), CRP (183 ± 25.21 vs. 93.78 ± 70.81 mg/L), IL-6 (3234.49 (713.51, 16038.36) vs. 181.29 (82.24, 521.39) pg/mL), IL-8 (154.86 (63.97, 1476.1) vs. 67.19 (27.84, 85.57) pg/mL), and IL-10 (17.43 (9.14, 41.22) vs. 4.97 (2.39, 8.70) pg/mL), APACHE II (29 ± 4.92 vs. 18.4 ± 2.07), and SOFA (17.2 ± 1.92 vs. 11.2 ± 3.4) significantly decreased (P < .05), while MAP (75.8 ± 4.92 vs. 85.8 ± 6.18 mm Hg), and PaO /FiO (101.2 ± 7.49 vs. 132.6 ± 26.15 mm Hg) significantly increased (P < .05). Among the five patients, negative conversion of nucleic acid test was found in three cases, while two cases died. No adverse events occurred during the treatment. Our study observed a reduced level of overexpressed cytokines, stabilization of hemodynamic status, and staged improvement of organ function during the treatment with Oxiris filter.

摘要

细胞因子在新型冠状病毒肺炎(COVID-19)患者中引起急性呼吸窘迫综合征(ARDS),这是入住重症监护病房治疗的主要原因,也是 COVID-19 患者死亡的主要原因。细胞因子风暴是 ARDS 发展的关键因素。本研究评估了 Oxiris 过滤器在 COVID-19 患者治疗中的疗效和安全性。2019 年 1 月 23 日至 2020 年 3 月 28 日期间,河南省人民医院连续肾脏替代治疗(CRRT)的 5 例 COVID-19 患者纳入本研究。比较 CRRT 前后心率(HR)、平均动脉压(MAP)、氧合指数(PaO/FiO)、肾功能、C 反应蛋白(CRP)、细胞因子、降钙素原(PCT)、急性生理学和慢性健康评估 II(APACHE II)、序贯器官衰竭评分(SOFA)和预后。纳入 5 例 COVID-19 患者,男 3 例,女 2 例,年龄 70.2±19.6 岁。治疗后,HR(101.4±14.08 比 83.8±6.22 bpm/min)、CRP(183±25.21 比 93.78±70.81 mg/L)、IL-6(3234.49(713.51,16038.36)比 181.29(82.24,521.39)pg/mL)、IL-8(154.86(63.97,1476.1)比 67.19(27.84,85.57)pg/mL)、IL-10(17.43(9.14,41.22)比 4.97(2.39,8.70)pg/mL)、APACHE II(29±4.92 比 18.4±2.07)、SOFA(17.2±1.92 比 11.2±3.4)明显降低(P<0.05),而 MAP(75.8±4.92 比 85.8±6.18 mmHg)和 PaO/FiO(101.2±7.49 比 132.6±26.15 mmHg)明显升高(P<0.05)。在这 5 例患者中,3 例发现核酸检测结果阴性转换,2 例死亡。治疗过程中未发生不良事件。我们的研究观察到在使用 Oxiris 过滤器治疗期间,过度表达的细胞因子水平降低,血流动力学状态稳定,器官功能分期改善。

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