Extracorporeal organ support in COVID-19 patients: Expert review and recommendation

In una recente Review pubblicata sulla rivista Blood Purification, un gruppo di esperti composto da Claudio Ronco, Sean M. Bagshaw, Rinaldo Bellomo, William R. Clark, Faeq Husain-Syed, John A. Kellum, Zaccaria Ricci, Thomas Rimmelé, Thiago Reis and Marlies Ostermann, ha discusso il ruolo delle terapie depurative extracorporee e di supporto d’organo nei pazienti critici affetti da COVID-19.

Il gruppo fornisce un’analisi di esperti e le raccomandazioni di utilizzo tra cui le indicazioni per la terapia Polymyxin B Hemoperfusion (Toraymyxin®)

In merito a Polymyxin B hemoperfusion (Toraymyxin®), gli autori affermano:

“In case of COVID-19 infection and CRS, with suspected or confirmed superimposed Gram-negative bacterial infections, the use of PMX-HP is indicated in the early phases to provide endotoxin adsorption. PMX-HP should be used for 2 subsequent days. If CRS is present, this treatment should be followed by methods for cytokine adsorption […], and if organ support is required, CRRT should be implemented in conjunction or afterward. Such treatment of endotoxin removal, cytokine removal, and organ support along the course of the ICU stay is referred to as sequential extracorporeal therapy. Thus, ECOS represents the perfect combination of techniques to provide blood purification in COVID-19 patients”.

In merito alle raccomandazioni pratiche per la gestione del paziente critico affetto da COVID-19, gli autori in merito a Polymyxin B hemoperfusion (Toraymyxin®) affermano:

“In the future, genetic profiling may guide the initiation of this therapeutic strategy for specific patients. If PMX-HP is indicated for suspected sepsis (high procalcitonin and/or positive bacterial culture) or confirmed by elevated endotoxin activity assay, 2-h sessions in 2 subsequent days are advised. A third session might be required in some patients”.

L’articolo è disponibile qui.

Blood Purif, 2020 May 26;1-11