Sequential Extracorporeal Blood Purification Is Associated with Prolonged Survival among ICU Patients with COVID-19 and Confirmed Bacterial Superinfection.

INTRODUCTION: This study investigates the impact of sequential extracorporeal treatments with oXiris® or CytoSorb® plus Seraph-100® on the clinical and laboratory parameters of critically ill COVID-19 patients with bacterial superinfection. METHODS: Patients admitted to the intensive care unit with COVID-19, bacterial superinfection, and undergoing blood purification (BP) were enrolled in this prospective, single-center, observational study. "standard BP" with oXiris® or CytoSorb® were used in 35 COVID-19 patients with bacterial infection. Seraph-100® was added in 33 patients when available serially in the same oXiris® circuit or as sequential treatment with CytoSorb® as a sequential BP. RESULTS: A significant reduction in SOFA score 3 days after treatment was observed in patients undergoing sequential BP (11.3 vs. 8.17, p < 0.01) compared to those undergoing "standard BP" (11.0 vs. 10.3, p > 0.05). The difference between the observed and expected mortality rate based on APACHE IV was greater in the sequential BP group (42.4% vs. 81.7%, p < 0.001) than the "standard BP" (74.2% vs. 81.7%, p > 0.05). Patients treated with sequential BP had a longer survival than those treated with "standard BP" (22.4 vs. 18.7 months; p < 0.001). CONCLUSIONS: The sequential approach may enhance the positive effect of BP on organ dysfunction among critically ill patients with COVID-19 and bacterial superinfection.

The Influence of the Age, the Years of Training, and the BMI on the Average Muscle Power in Male and Female Rowers.

The aim of the study was to evaluate the influence of the age, the body mass index (BMI), and the years of training on the average muscle power in male and female rowers. The analysis of the testing results of the members of the Rowing club Iktus from Osijek in Croatia was performed. Results were obtained during the regular yearly testing on the rowing ergometer for the rowing season of 2009. Members of the Rowing club Iktus were divided into two subgroups according to their sex. The obtained results were analysed in accordance with the age, the BMI, and the years of training independently for the each of the two subgroups. The results have showed that the average muscle power is independent of all the three parameters in the male rowers, while it is dependent on the age and the years of training in the female rowers. It seems that the BMI does not play any role at all in the average muscle power. As a conclusion, it could be stated that while one can suggest to female rowers to improve their performance with prolonged training, there is a need for a further research in order to formulate a suitable advice for male rowers.

Impaired kidney function in rats six months after unilateral nephrectomy - an old story, a new perspective.

AIM: Despite of routinely practised living kidney transplantation, data on consequences and impact of unilateral nephrectomy on the quality of life and health of donors are scarce. The aim of the present study was to examine long-term changes and function of the remnant kidney after unilateral nephrectomy in an animal model. METHODS: Thirty six female Sprague - Dawley rats at 4 months of age were randomized into the three groups: unilaterally nephrectomized, sham operated and naïve rats. The nephrectomy was done at inclusion in the experiment and their blood was taken at inclusion and six months thereafter. RESULTS: There was a significant increase in serum creatinine concentrations six months after unilateral nephrectomy (39.7 ± 0.8 µmol/l) in comparison with the sham operated (30.1 ± 1.1 µmol/l) and the naïve rats (26.3 ± 3 µmol/l) (p ≤ 0.001). Serum sodium levels remained unchanged (p=0.116). Blood haemoglobin concentration did not differ between the three groups (p=0.115). CONCLUSIONS: Although it has been very well established that kidney possesses huge capacity to compensate severe loss of renal mass, our results implicate that renal function undergoes significant deterioration with time after unilateral nephrectomy. Fortunately, in everyday clinical practice we do not see severe renal dysfunction in patients with a single kidney. However, prolongation of the human life span in the future could face us with renal impairment in living kidney donors. Future examination of specific biomarkers in our rat model (e.g. growth factors) could support our findings.