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The Sequential Use of Extracorporeal Cytokine Removal Devices in an Adolescent With COVID-19 Receiving Continuous Renal Replacement Therapy.
Hui, Wun Fung; Chan, Renee Wan Yi; Wong, Chun Kwok; Kwok, Ka Hang Andy; Cheung, Wing Lum; Chung, Fung Shan; Leung, Karen Ka Yan; Hon, Kam Lun; Ku, Shu Wing.
  • Hui WF; From the Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong.
  • Chan RWY; Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
  • Wong CK; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong.
  • Kwok KHA; Laboratory for Paediatric Respiratory Research, Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
  • Cheung WL; CUHK-UMCU Joint Research Laboratory of Respiratory Virus & Immunobiology, Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
  • Chung FS; Department of Chemical Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
  • Leung KKY; From the Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong.
  • Hon KL; From the Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong.
  • Ku SW; From the Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong.
ASAIO J ; 68(12): e230-e234, 2022 Dec 01.
Article in English | MEDLINE | ID: covidwho-2097503
ABSTRACT
A 14-year-old male developed multisystem inflammatory syndrome in children (MIS-C) after acquiring the SARS-CoV-2 infection. He deteriorated rapidly requiring inotropic and ventilatory support as well as continuous renal replacement therapy (CRRT) due to rhabdomyolysis-associated acute kidney injury. A hemoadsoprtion column Cytosorb® was first incorporated into the CRRT circuit for myoglobin and cytokines removal, which was followed by sequential use of another type of cytokine-removing hemofilter (Oxiris®) (altogether 100 hours of extracorporeal blood purification [EBP] therapy). There was no major complication related to the EBP therapy. Cytokine profile revealed a marked reduction of levels of several cytokines including tumor necrosis factor-α, interleukin (IL)-6, IL-8, and IL-10 after the EBP therapy. It was noted that both pro-inflammatory and anti-inflammatory cytokines were removed, and the removal efficacy varied between different devices. His condition improved and the serum ferritin, C-reactive protein, and procalcitonin levels also dropped gradually, which correlated well with his clinical progress and the trend of cytokine levels. Our case demonstrated that extracorporeal cytokine removal can be safely applied in children with MIS-C and can be considered as adjunctive therapy in selected patients with critically ill conditions.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Continuous Renal Replacement Therapy / COVID-19 Type of study: Case report / Prognostic study Topics: Long Covid Limits: Adolescent / Child / Humans / Male Language: English Journal: ASAIO J Journal subject: Transplantation Year: 2022 Document Type: Article Affiliation country: Mat.0000000000001834

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Continuous Renal Replacement Therapy / COVID-19 Type of study: Case report / Prognostic study Topics: Long Covid Limits: Adolescent / Child / Humans / Male Language: English Journal: ASAIO J Journal subject: Transplantation Year: 2022 Document Type: Article Affiliation country: Mat.0000000000001834