Kurniawan Aldrich, Partiningrum Dwi Lestari, Olivera Ivona, Sanjaya Steffani, Djunarko Josephine, Yusri Nurul Hasanah, Tandarto Kevin
Department of Internal Medicine, Columbia Asia Hospital, Semarang, Indonesia.
Intensive Care Unit, Columbia Asia Hospital, Semarang, Indonesia.
J Infect Dev Ctries. 2024 Dec 31;18(12.1):S206-S213. doi: 10.3855/jidc.19751.
Hemoperfusion (HP), a blood filtration method targeting the removal of toxins and inflammatory elements, was investigated in this study. The objective was to present the observations in four individuals with confirmed COVID-19 who underwent several rounds of HP utilizing the HA330 cartridge at a hospital in Indonesia.
We report four cases of COVID-19 patients who underwent HP. The decision to start HP in COVID-19 patients hinges on severe illness and specific indications such as refractory hypercytokinemia or cytokine storm syndrome, despite conventional treatments. Inclusion criteria were evidence of organ dysfunction; particularly the lungs, kidneys, or liver; and significant inflammatory markers or laboratory abnormalities. The four cases described here received HP as a supplementary treatment for COVID-19. However, only two of these patients successfully finished three cycles of HP, and just one exhibited improvement and was eventually declared to have recovered.
The rationale behind HP in COVID-19 patients lies in its potential to mitigate the cytokine storm, a hallmark of severe disease. COVID-19 is known to trigger an excessive inflammatory response, leading to organ damage and respiratory distress. HP, through the use of devices such as the HA330 cartridge, aims to remove inflammatory cytokines and toxins from blood circulation. Utilizing at least three sessions of HA-330 HP in addition to standard treatment in severe COVID-19 demonstrated a beneficial effect on decreasing inflammatory biomarkers, although it did not affect mortality rates.
血液灌流(HP)是一种旨在清除毒素和炎症因子的血液滤过方法,本研究对其进行了调查。目的是介绍在印度尼西亚一家医院对4名确诊为COVID-19的患者进行多轮使用HA330灌流器的血液灌流的观察结果。
我们报告了4例接受血液灌流的COVID-19患者。尽管采用了常规治疗,但对于COVID-19患者开始进行血液灌流的决定取决于严重疾病以及难治性高细胞因子血症或细胞因子风暴综合征等特定指征。纳入标准为器官功能障碍的证据,特别是肺部、肾脏或肝脏;以及显著的炎症标志物或实验室异常。这里描述的4例患者接受血液灌流作为COVID-19的辅助治疗。然而,这些患者中只有2例成功完成了3个周期的血液灌流,只有1例病情有所改善并最终被宣布康复。
COVID-19患者进行血液灌流的基本原理在于其减轻细胞因子风暴的潜力,细胞因子风暴是重症疾病的一个标志。已知COVID-19会引发过度的炎症反应,导致器官损伤和呼吸窘迫。血液灌流通过使用HA330灌流器等设备,旨在从血液循环中清除炎症细胞因子和毒素。在重症COVID-19患者的标准治疗基础上,使用至少3次HA-330血液灌流对降低炎症生物标志物有有益作用,尽管它并未影响死亡率。