Mohamed Abdelaty, Adham Mohamed, Mohamed O Saad, Hassan Mitwally, Mohamad M Alkadi, Ahmed Hashim, Hassan Al Malki, Husain S Ali, Ahmed Soliman Mohamed, Emad Mustafa, Abdulaziz Alalawi, Moustafa Elshafei, Muftah Othman, Mohamad Khatib, Abdul-Salam Ibrahim
{"title":"使用Oxiris®过滤器对需要持续肾脏替代治疗的新冠肺炎危重患者进行体外血液净化。","authors":"Mohamed Abdelaty, Adham Mohamed, Mohamed O Saad, Hassan Mitwally, Mohamad M Alkadi, Ahmed Hashim, Hassan Al Malki, Husain S Ali, Ahmed Soliman Mohamed, Emad Mustafa, Abdulaziz Alalawi, Moustafa Elshafei, Muftah Othman, Mohamad Khatib, Abdul-Salam Ibrahim","doi":"10.1177/03913988231207716","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Severe COVID-19 is associated with a dysregulated immune response that usually leads to cytokine release syndrome. This study aimed to compare the use of extracorporeal blood purification therapy (Oxiris<sup>®</sup>) versus standard continuous renal replacement therapy (CRRT) in critically-ill patients with severe COVID-19.</p><p><strong>Methods: </strong>This was a national, multicenter, retrospective study of patients with COVID-19 admitted to the intensive care unit (ICU) between March and October 2020 who required CRRT. Patients were categorized into two groups: Oxiris<sup>®</sup> CRRT and standard CRRT. The primary outcome was the number of patients alive and ventilator-free at 30-days post-CRRT treatment. Key secondary endpoints included change in inflammatory markers, Sequential Organ Failure Assessment (SOFA) scores, and PaO<sub>2</sub>/FiO<sub>2</sub> ratio at 24- and 72-h post Oxiris<sup>®</sup> initiation.</p><p><strong>Results: </strong>Thirty-five patients received Oxiris<sup>®</sup> CRRT and 23 patients received standard CRRT. The primary outcome was 31.4% in the Oxiris<sup>®</sup> group versus 4.3% in the standard CRRT group (adjusted odds ratio 5.97, 95% confidence interval [CI], 0.64-55.6; <i>p</i> = 0.117). In the Oxiris<sup>®</sup> group, interleukin-6 (IL-6) concentrations significantly decreased at 24 and 72-h (<i>p</i> = 0.033) and PaO<sub>2</sub>/FiO<sub>2</sub> ratio significantly increased at 24 and 72 h after Oxiris<sup>®</sup> initiation (<i>p</i> = 0.001). There was no significant change in SOFA scores at 24- and 72-h after Oxiris<sup>®</sup> initiation.</p><p><strong>Conclusion: </strong>The number of patients alive and ventilator-free at 30-days was higher in the Oxiris<sup>®</sup> group than that in the standard CRRT group; however, the difference did not reach statistical significance after adjusting for the baseline severity of illness. There was a significant reduction in IL-6 and significant improvement in PaO<sub>2</sub>/FiO<sub>2</sub> ratio after Oxiris<sup>®</sup> CRRT initiation.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Extracorporeal blood purification with Oxiris<sup>®</sup> filter in critically ill patients with COVID-19 requiring continuous renal replacement therapy.\",\"authors\":\"Mohamed Abdelaty, Adham Mohamed, Mohamed O Saad, Hassan Mitwally, Mohamad M Alkadi, Ahmed Hashim, Hassan Al Malki, Husain S Ali, Ahmed Soliman Mohamed, Emad Mustafa, Abdulaziz Alalawi, Moustafa Elshafei, Muftah Othman, Mohamad Khatib, Abdul-Salam Ibrahim\",\"doi\":\"10.1177/03913988231207716\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Severe COVID-19 is associated with a dysregulated immune response that usually leads to cytokine release syndrome. This study aimed to compare the use of extracorporeal blood purification therapy (Oxiris<sup>®</sup>) versus standard continuous renal replacement therapy (CRRT) in critically-ill patients with severe COVID-19.</p><p><strong>Methods: </strong>This was a national, multicenter, retrospective study of patients with COVID-19 admitted to the intensive care unit (ICU) between March and October 2020 who required CRRT. Patients were categorized into two groups: Oxiris<sup>®</sup> CRRT and standard CRRT. The primary outcome was the number of patients alive and ventilator-free at 30-days post-CRRT treatment. Key secondary endpoints included change in inflammatory markers, Sequential Organ Failure Assessment (SOFA) scores, and PaO<sub>2</sub>/FiO<sub>2</sub> ratio at 24- and 72-h post Oxiris<sup>®</sup> initiation.</p><p><strong>Results: </strong>Thirty-five patients received Oxiris<sup>®</sup> CRRT and 23 patients received standard CRRT. The primary outcome was 31.4% in the Oxiris<sup>®</sup> group versus 4.3% in the standard CRRT group (adjusted odds ratio 5.97, 95% confidence interval [CI], 0.64-55.6; <i>p</i> = 0.117). In the Oxiris<sup>®</sup> group, interleukin-6 (IL-6) concentrations significantly decreased at 24 and 72-h (<i>p</i> = 0.033) and PaO<sub>2</sub>/FiO<sub>2</sub> ratio significantly increased at 24 and 72 h after Oxiris<sup>®</sup> initiation (<i>p</i> = 0.001). There was no significant change in SOFA scores at 24- and 72-h after Oxiris<sup>®</sup> initiation.</p><p><strong>Conclusion: </strong>The number of patients alive and ventilator-free at 30-days was higher in the Oxiris<sup>®</sup> group than that in the standard CRRT group; however, the difference did not reach statistical significance after adjusting for the baseline severity of illness. There was a significant reduction in IL-6 and significant improvement in PaO<sub>2</sub>/FiO<sub>2</sub> ratio after Oxiris<sup>®</sup> CRRT initiation.</p>\",\"PeriodicalId\":13932,\"journal\":{\"name\":\"International Journal of Artificial Organs\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2023-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Artificial Organs\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.1177/03913988231207716\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/11/5 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"ENGINEERING, BIOMEDICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Artificial Organs","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1177/03913988231207716","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/11/5 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
Extracorporeal blood purification with Oxiris® filter in critically ill patients with COVID-19 requiring continuous renal replacement therapy.
Introduction: Severe COVID-19 is associated with a dysregulated immune response that usually leads to cytokine release syndrome. This study aimed to compare the use of extracorporeal blood purification therapy (Oxiris®) versus standard continuous renal replacement therapy (CRRT) in critically-ill patients with severe COVID-19.
Methods: This was a national, multicenter, retrospective study of patients with COVID-19 admitted to the intensive care unit (ICU) between March and October 2020 who required CRRT. Patients were categorized into two groups: Oxiris® CRRT and standard CRRT. The primary outcome was the number of patients alive and ventilator-free at 30-days post-CRRT treatment. Key secondary endpoints included change in inflammatory markers, Sequential Organ Failure Assessment (SOFA) scores, and PaO2/FiO2 ratio at 24- and 72-h post Oxiris® initiation.
Results: Thirty-five patients received Oxiris® CRRT and 23 patients received standard CRRT. The primary outcome was 31.4% in the Oxiris® group versus 4.3% in the standard CRRT group (adjusted odds ratio 5.97, 95% confidence interval [CI], 0.64-55.6; p = 0.117). In the Oxiris® group, interleukin-6 (IL-6) concentrations significantly decreased at 24 and 72-h (p = 0.033) and PaO2/FiO2 ratio significantly increased at 24 and 72 h after Oxiris® initiation (p = 0.001). There was no significant change in SOFA scores at 24- and 72-h after Oxiris® initiation.
Conclusion: The number of patients alive and ventilator-free at 30-days was higher in the Oxiris® group than that in the standard CRRT group; however, the difference did not reach statistical significance after adjusting for the baseline severity of illness. There was a significant reduction in IL-6 and significant improvement in PaO2/FiO2 ratio after Oxiris® CRRT initiation.
期刊介绍:
The International Journal of Artificial Organs (IJAO) publishes peer-reviewed research and clinical, experimental and theoretical, contributions to the field of artificial, bioartificial and tissue-engineered organs. The mission of the IJAO is to foster the development and optimization of artificial, bioartificial and tissue-engineered organs, for implantation or use in procedures, to treat functional deficits of all human tissues and organs.