Your browser doesn't support javascript.
Successful Treatment of a Critically Ill COVID-19 Patient Using Continuous Renal Replacement Therapy With Enhanced Cytokine Removal and Tocilizumab: A Case Report.
Huang, Thomas Tao-Min; Chien, Ying-Chun; Wang, Chih-Hsien; Chang, Sui-Yuan; Wang, Jann-Tay; Hsieh, Song-Chou; Yeh, Yu-Chang; Ku, Shih-Chi; Yu, Chong-Jen; Chiang, Bor-Luen; Chang, Shan-Chwen; Tolwani, Ashita.
  • Huang TT; Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
  • Chien YC; Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
  • Wang CH; Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
  • Chang SY; Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan.
  • Wang JT; Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
  • Hsieh SC; Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
  • Yeh YC; Department of Anesthesiology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
  • Ku SC; Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
  • Yu CJ; Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
  • Chiang BL; Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
  • Chang SC; Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
  • Tolwani A; Division of Nephrology, University of Alabama, Birmingham, AL, United States.
Front Med (Lausanne) ; 8: 649583, 2021.
Article in English | MEDLINE | ID: covidwho-1282392
ABSTRACT
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.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Prognostic study Language: English Journal: Front Med (Lausanne) Year: 2021 Document Type: Article Affiliation country: Fmed.2021.649583

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Prognostic study Language: English Journal: Front Med (Lausanne) Year: 2021 Document Type: Article Affiliation country: Fmed.2021.649583