Phan Phuc H, Nguyen Dung T, Dao Nam H, Nguyen Ha T T, Vu An V, Hoang Son T, Nguyen Lam V, Cao Tung V, Tran Dien M
Pediatric COVID-19 Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam.
Cardiovascular Center, Vietnam National Children's Hospital, Hanoi, Vietnam.
Front Pediatr. 2022 Jul 12;10:946547. doi: 10.3389/fped.2022.946547. eCollection 2022.
Indirect cardiomyocyte damage-related hyperinflammatory response is one of the key mechanisms in COVID-19-induced fulminant myocarditis. In addition to the clinical benefit of using cytokines absorption hemofiltration, the effectiveness of instituting veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support for cardiac compromise has been reported. However, current literature enunciates a paucity of available data on the effectiveness of these novel modalities.
We reported a 9-year-old boy with recurrent COVID-19 infection-causing fulminant myocarditis, who was treated successfully by using novel modalities of hemofilter continuous venovenous hemofiltration (CVVH) and VA-ECMO. The patient made a full recovery without any sequelae.
We conclude that the novel highly-absorptive hemofilter CVVH and VA-ECMO may be effective treatment modalities in managing SARS-CoV-2-induced fulminant myocarditis. Our report highlights the need for further well-designed investigations to confirm this extrapolation.
间接心肌细胞损伤相关的过度炎症反应是新型冠状病毒肺炎（COVID-19）诱发暴发性心肌炎的关键机制之一。除了细胞因子吸附血液滤过的临床益处外，已有报道采用静脉-动脉体外膜肺氧合（VA-ECMO）支持治疗心脏功能不全的有效性。然而，目前的文献表明关于这些新方法有效性的可用数据很少。
我们报告了一名9岁男孩，因复发性COVID-19感染导致暴发性心肌炎，通过使用血液滤过器持续静脉-静脉血液滤过（CVVH）和VA-ECMO的新方法成功治疗。患者完全康复，无任何后遗症。
我们得出结论，新型高吸附性血液滤过器CVVH和VA-ECMO可能是治疗严重急性呼吸综合征冠状病毒2（SARS-CoV-2）诱发的暴发性心肌炎的有效治疗方法。我们的报告强调需要进一步进行精心设计的研究来证实这一推断。
