危重老年COVID-19肾衰患者细胞因子吸收:503例重症监护病房患者回顾性分析

IF 2.1 4区医学 Q3 HEMATOLOGY

Clinical hemorheology and microcirculation Pub Date : 2023-01-01 DOI:10.3233/CH-221579

Stephan Binneboessel, Raphael Romano Bruno, Bernhard Wernly, Maryna Masyuk, Hans Flaatten, Jesper Fjølner, Georg Wolff, Malte Kelm, Michael Beil, Sigal Sviri, Wojciech Szczeklik, Susannah Leaver, Dylan W De Lange, Bertrand Guidet, Christian Jung

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引用次数: 0

摘要

背景：新冠肺炎与危重疾病状态下细胞因子的释放有关。因此，细胞因子吸收已被提议作为一种治疗选择。本研究调查了入住重症监护室（ICU）的新冠肺炎和肾衰竭老年危重患者的细胞因子吸收对死亡率的影响。方法：这项前瞻性国际观察研究（COVIP研究）的回顾性分析分析分析了≥70岁的新冠肺炎重症监护室患者。收集了顺序器官衰竭评估（SOFA）评分、临床虚弱量表（CFS）、ICU治疗细节（包括有/无细胞因子吸收的肾脏替代治疗（RRT））的数据。将细胞因子吸收组与接受RRT但没有细胞因子吸收的患者进行比较。结果：3927名患者中，503人接受了RRT；其中47例接受细胞因子吸收治疗。两组的死亡率都很高，细胞因子组的ICU死亡率和30天死亡率增加，但3个月死亡率没有增加。Logistic回归分析表明，SOFA评分与死亡率相关，但与细胞因子吸收无关。结论：与单独接受肾脏替代治疗的患者相比，接受细胞因子吸收治疗的重症新冠肺炎肾衰竭患者的短期死亡率更高。在多变量分析中，死亡率与疾病严重程度相关，但与细胞因子吸收无关。

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Cytokine absorption in critically ill old COVID-19 patients with renal failure: A retrospective analysis of 503 intensive care unit patients.

Background: COVID-19 is associated with cytokine release in critical disease states. Thus, cytokine absorption has been proposed as a therapeutic option. This study investigated the influence of cytokine absorption on mortality in old critical patients with COVID-19 and renal failure admitted to intensive care units (ICU).

Methods: This retrospective analysis of a prospective international observation study (the COVIP study) analysed ICU patients≥70 years with COVID-19. Data on Sequential Organ Failure Assessment (SOFA) score, clinical frailty scale (CFS), ICU therapy details including renal replacement therapy (RRT) with/without cytokine absorption were collected. The cytokine absorption group was compared to patients receiving RRT without cytokine absorptionRESULTS:Among 3927 patients, 503 received RRT; among them 47 patients were treated with cytokine absorption. Mortality rates were high in both groups with increased rates in the cytokine group for ICU mortality and 30-day mortality, but not for 3-month mortality. Logistic regression analysis indicated that SOFA-score, but not cytokine absorption was associated with mortality.

Conclusions: Critical COVID-19 patients with renal failure treated with cytokine absorption showed higher short term mortality rates when compared to patients with renal replacement therapy alone. Mortality is associated with disease severity, but not cytokine absorption in a multivariate analysis.

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来源期刊

Clinical hemorheology and microcirculation 医学-外周血管病

CiteScore

4.30

自引率

33.30%

发文量

170

期刊介绍： Clinical Hemorheology and Microcirculation, a peer-reviewed international scientific journal, serves as an aid to understanding the flow properties of blood and the relationship to normal and abnormal physiology. The rapidly expanding science of hemorheology concerns blood, its components and the blood vessels with which blood interacts. It includes perihemorheology, i.e., the rheology of fluid and structures in the perivascular and interstitial spaces as well as the lymphatic system. The clinical aspects include pathogenesis, symptomatology and diagnostic methods, and the fields of prophylaxis and therapy in all branches of medicine and surgery, pharmacology and drug research. The endeavour of the Editors-in-Chief and publishers of Clinical Hemorheology and Microcirculation is to bring together contributions from those working in various fields related to blood flow all over the world. The editors of Clinical Hemorheology and Microcirculation are from those countries in Europe, Asia, Australia and America where appreciable work in clinical hemorheology and microcirculation is being carried out. Each editor takes responsibility to decide on the acceptance of a manuscript. He is required to have the manuscript appraised by two referees and may be one of them himself. The executive editorial office, to which the manuscripts have been submitted, is responsible for rapid handling of the reviewing process. Clinical Hemorheology and Microcirculation accepts original papers, brief communications, mini-reports and letters to the Editors-in-Chief. Review articles, providing general views and new insights into related subjects, are regularly invited by the Editors-in-Chief. Proceedings of international and national conferences on clinical hemorheology (in original form or as abstracts) complete the range of editorial features.