肾脏替代疗法
医学
体外
细胞因子
降钙素原
血液滤过
急性肾损伤
细胞激素风暴
体外循环
横纹肌溶解症
败血症
内科学
2019年冠状病毒病(COVID-19)
免疫学
麻醉
血液透析
疾病
传染病(医学专业)
作者
Wun Fung Hui,Renee W. Y. Chan,Chun Kwok Wong,Ka Hang Andy Kwok,Wing Lum Cheung,Fung Shan Chung,Karen Ka Yan Leung,Kam Lun Hon,Shu Wing Ku
出处
期刊:Asaio Journal
[Ovid Technologies (Wolters Kluwer)]
日期:2022-10-30
卷期号:68 (12): e230-e234
被引量:2
标识
DOI:10.1097/mat.0000000000001834
摘要
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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