期刊论文详细信息
Frontiers in Medicine
Successful Treatment of a Critically Ill COVID-19 Patient Using Continuous Renal Replacement Therapy With Enhanced Cytokine Removal and Tocilizumab: A Case Report
article
Thomas Tao-Min Huang1  Bor-Luen Chiang2  Shan-Chwen Chang1  Ashita Tolwani3  Ying-Chun Chien1  Chih-Hsien Wang4  Sui-Yuan Chang5  Jann-Tay Wang1  Song-Chou Hsieh1  Yu-Chang Yeh6  Shih-Chi Ku1  Chong-Jen Yu1 
[1] Department of Internal Medicine, National Taiwan University Hospital and College of Medicine;Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University;Division of Nephrology, University of Alabama, United States;Department of Surgery, National Taiwan University Hospital and College of Medicine;Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine;Department of Anesthesiology, National Taiwan University Hospital and College of Medicine
关键词: COVID-19;    cytokine release syndrome;    extracorporeal membrane oxygenation;    continuous renal replacement therapy;    tocilizumab;   
DOI  :  10.3389/fmed.2021.649583
学科分类:社会科学、人文和艺术(综合)
来源: Frontiers
PDF
【 摘 要 】

The COVID-19 pandemic has caused multiple deaths worldwide. Since no specific therapies are currently available, treatment for critically ill patients with COVID-19 is supportive. The most severe patients need sustained life support for recovery. We herein describe the course of a critically ill COVID-19 patient with multi-organ failure, including acute respiratory failure, acute kidney injury, and fulminant cytokine release syndrome (CRS), who required mechanical ventilation and extracorporeal membrane oxygenation support. This patient with a predicted high mortality risk was successfully managed with a careful strategy of oxygenation, uremic toxin removal, hemodynamic support, and most importantly, cytokine-targeted intervention for CRS, including cytokine/endotoxin removal, anti-cytokine therapy, and immune modulation. Comprehensive cytokine data, CRS parameters, and biochemical data of extracorporeal removal were provided to strengthen the rationale of this strategy. In this report, we demonstrate that timely combined hemoperfusion with cytokine adsorptive capacity and anti-cytokine therapy can successfully treat COVID-19 patients with fulminant CRS. It also highlights the importance of implementing cytokine-targeted therapy for severe COVID-19 guided by the precise measurement of disease activity.

【 授权许可】

CC BY   

【 预 览 】
附件列表
Files Size Format View
RO202108180000454ZK.pdf 913KB PDF download
  文献评价指标  
  下载次数:1次 浏览次数:0次