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体外治疗在危重症 COVID-19 患者中的应用。

Application of extracorporeal therapies in critically ill COVID-19 patients.

机构信息

Department of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University, Chengdu 610041, China.

Renal Division, Peking University First Hospital, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China, Beijing 100034, China.

出版信息

J Zhejiang Univ Sci B. 2021;22(9):701-717. doi: 10.1631/jzus.B2100344.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic is a major public health event caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 has spread widely all over the world. A high proportion of patients become severely or critically ill, and suffer high mortality due to respiratory failure and multiple organ dysfunction. Therefore, providing timely and effective treatment for critically ill patients is essential to reduce overall mortality. Convalescent plasma therapy and pharmacological treatments, such as aerosol inhalation of interferon-α (IFN-α), corticosteroids, and tocilizumab, have all been applied in clinical practice; however, their effects remain controversial. Recent studies have shown that extracorporeal therapies might have a potential role in treating critically ill COVID-19 patients. In this review, we examine the application of continuous renal replacement therapy (CRRT), therapeutic plasma exchange (TPE), hemoadsorption (HA), extracorporeal membrane oxygenation (ECMO), and extracorporeal carbon dioxide removal (ECCOR) in critically ill COVID-19 patients to provide support for the further diagnosis and treatment of COVID-19.

摘要

2019 年冠状病毒病(COVID-19)大流行是由严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)引起的重大公共卫生事件。COVID-19 已在全球广泛传播。相当比例的患者病情严重或危急,由于呼吸衰竭和多器官功能障碍而导致高死亡率。因此,为危重症患者提供及时有效的治疗对于降低总体死亡率至关重要。在临床实践中,已应用恢复期血浆疗法和药物治疗,如干扰素-α(IFN-α)雾化吸入、皮质类固醇和托珠单抗,但它们的效果仍存在争议。最近的研究表明,体外治疗可能在治疗危重症 COVID-19 患者方面具有潜在作用。在这篇综述中,我们探讨了连续性肾脏替代疗法(CRRT)、治疗性血浆置换(TPE)、血液吸附(HA)、体外膜氧合(ECMO)和体外二氧化碳去除(ECCOR)在危重症 COVID-19 患者中的应用,为 COVID-19 的进一步诊断和治疗提供支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b4/8435342/1aff078fe844/JZhejiangUnivSciB-22-9-701-g001.jpg

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