医学
心源性休克
变向性
重症监护室
SAPS II型
体外
沙发评分
血液滤过
体外膜肺氧合
器官功能障碍
休克(循环)
人口
感染性休克
肾脏替代疗法
内科学
心脏病学
心肌梗塞
阿帕奇II
败血症
血液透析
环境卫生
作者
Marina Pieri,Matteo Aldo Bonizzoni,Alessandro Belletti,Maria Grazia Calabrò,Evgeny Fominskiy,Pasquale Nardelli,Alessandro Ortalda,Anna Mara Scandroglio
出处
期刊:Blood Purification
[S. Karger AG]
日期:2023-01-01
卷期号:52 (9-10): 759-767
被引量:2
摘要
Critically ill patients with inflammatory dysregulation and organ disfunction may benefit from blood purification, although the use of this technique has not been described in large case series. We evaluated clinical outcomes and survival in high-risk intensive care unit (ICU) patients who underwent extracorporeal blood purification.359 consecutive ICU patients treated with CytoSorb were included.Main admission diagnoses were 120 (34%) refractory cardiac arrest under mechanical chest compression; 101 (28%) profound cardiogenic shock; 81 (23%) post-cardiotomy cardiogenic shock; and 37 (10%) respiratory failure. Fifteen patients (4%) were positive for SARS-CoV-2 infection. We observed 49% 30-day mortality, 57% ICU mortality, and 62% hospital mortality, all lower than the 71% mortality predicted by SAPS II and 68% predicted by SOFA score. Parameters of shock and organ failure, above all vasoactive inotropic score, reduced during CytoSorb treatment. Multivariable analysis identified SAPS II, lactate dehydrogenase, ICU stay duration, vasoactive inotropic score, lactates, intra-aortic counterpulsation on top of VA-ECMO, and total bilirubin as predictors of mortality. No CytoSorb-related complications occurred.CytoSorb treatment was effective in reducing laboratory parameters of shock and vasoactive inotropic score with possible survival implications in a large population of critically ill patients.
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