Critically ill patients with COVID-19 with ECMO and artificial liver plasma exchange A retrospective study

被引:15
作者
Liu, Jian [2 ]
Dong, Yong-Quan [3 ]
Yin, Jie [5 ]
He, Guojun [2 ]
Wu, Xiaoxin [4 ]
Li, Jianping [1 ]
Qiu, Yunqing [4 ]
He, Xuelin [6 ]
机构
[1] Zhejiang Univ, Affiliated Hosp 1, Coll Med, Dept Tradit Chinese Med, Hangzhou, Peoples R China
[2] Zhejiang Univ, Affiliated Hosp 1, Coll Med, Dept Intens Care Unit, Hangzhou, Peoples R China
[3] Yinzhou 2 Hosp, Dept Resp Dis, Ningbo, Peoples R China
[4] Zhejiang Univ, Affiliated Hosp 1, Coll Med, Dept Infect Dis, Hangzhou, Zhejiang, Peoples R China
[5] Zhejiang Univ, Affiliated Hosp 1, Coll Med, Dept Radiat Oncol, Hangzhou, Zhejiang, Peoples R China
[6] Zhejiang Univ, Affiliated Hosp 1, Coll Med, Dept Kidney Dis Ctr, Hangzhou, Zhejiang, Peoples R China
关键词
artificial liver plasma exchange; COVID-19; critically; ECMO; ill; CLINICAL CHARACTERISTICS; CYTOKINE; PNEUMONIA; IL-6;
D O I
10.1097/MD.0000000000021012
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
COVID-19 is an emerging infectious disease capable of causing severe pneumonia. We aimed to characterize a group of critically ill patients in a single-center study. This was a retrospective case series of 23 patients with confirmed COVID-19-related critical illness in the intensive care unit (ICU) of a hospital in Hangzhou Zhejiang Province between January 22 and March 20, 2020. Of the 23 critically ill patients, the median age was 66 years (interquartile range [IQR] 59-80 years). The median time from disease onset to ICU admission was 10 days (IQR 6-11 days), to mechanical ventilation (MV) was 11 days (IQR 7.75-13 days), to artificial liver plasma exchange was 12 days (IQR 9.75-14.75 days), and to extracorporeal membrane oxygenation (ECMO) was 22 days (IQR 17.5-30 days). Nine patients required high flow oxygen. Fourteen patients received MV. Six required ECMO. Nine received artificial liver plasma exchange. Mortality was 0 at day 28. Mortality was 0 at day 28 in our single-center study. Extracorporeal membrane oxygenation reduced the requirements for ventilator support. Artificial liver plasma exchange significantly reduced inflammatory cytokine levels. These supportive therapies helped to extend the patients' survival times and increase the chance of follow-up treatments.
引用
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页数:7
相关论文
共 28 条
[1]  
[Anonymous], ZHEJIANG DA XUE XUE
[2]   Lymphopenic Community Acquired Pneumonia (L-CAP), an Immunological Phenotype Associated with Higher Risk of Mortality [J].
Bermejo-Martin, Jesus F. ;
Cilloniz, Catia ;
Mendez, Raul ;
Almansa, Raquel ;
Gabarrus, Albert ;
Ceccato, Adrian ;
Torres, Antoni ;
Menendez, Rosario .
EBIOMEDICINE, 2017, 24 :231-236
[3]  
Brower RG, 2004, NEW ENGL J MED, V351, P327
[4]   Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. [J].
Brower, RG ;
Matthay, MA ;
Morris, A ;
Schoenfeld, D ;
Thompson, BT ;
Wheeler, A ;
Wiedemann, HP ;
Arroliga, AC ;
Fisher, CJ ;
Komara, JJ ;
Perez-Trepichio, P ;
Parsons, PE ;
Wolkin, R ;
Welsh, C ;
Fulkerson, WJ ;
MacIntyre, N ;
Mallatratt, L ;
Sebastian, M ;
McConnell, R ;
Wilcox, C ;
Govert, J ;
Thompson, D ;
Clemmer, T ;
Davis, R ;
Orme, J ;
Weaver, L ;
Grissom, C ;
Eskelson, M ;
Young, M ;
Gooder, V ;
McBride, K ;
Lawton, C ;
d'Hulst, J ;
Peerless, JR ;
Smith, C ;
Brownlee, J ;
Pluss, W ;
Kallet, R ;
Luce, JM ;
Gottlieb, J ;
Elmer, M ;
Girod, A ;
Park, P ;
Daniel, B ;
Gropper, M ;
Abraham, E ;
Piedalue, F ;
Glodowski, J ;
Lockrem, J ;
McIntyre, R .
NEW ENGLAND JOURNAL OF MEDICINE, 2000, 342 (18) :1301-1308
[5]   Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study [J].
Chen, Nanshan ;
Zhou, Min ;
Dong, Xuan ;
Qu, Jieming ;
Gong, Fengyun ;
Han, Yang ;
Qiu, Yang ;
Wang, Jingli ;
Liu, Ying ;
Wei, Yuan ;
Xia, Jia'an ;
Yu, Ting ;
Zhang, Xinxin ;
Zhang, Li .
LANCET, 2020, 395 (10223) :507-513
[6]   Treatment of severe acute respiratory syndrome with glucosteroids - The Guangzhou experience [J].
Chen, Rong-chang ;
Tang, Xiao-ping ;
Tan, Shou-yong ;
Liang, Bi-ling ;
Wan, Zhuo-yue ;
Fang, Ji-qian ;
Zhong, Nanshan .
CHEST, 2006, 129 (06) :1441-1452
[7]   Critically ill patients with severe acute respiratory syndrome [J].
Fowler, RA ;
Lapinsky, SE ;
Hallett, D ;
Detsky, AS ;
Sibbald, WJ ;
Slutsky, AS ;
Stewart, TE .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2003, 290 (03) :367-373
[8]  
Guan WJ, 2020, NEW ENGL J MED, V382, P1861, DOI 10.1056/NEJMc2005203
[9]   ECMO for Severe ARDS [J].
Hardin, C. Corey ;
Hibbert, Kathryn .
NEW ENGLAND JOURNAL OF MEDICINE, 2018, 378 (21) :2032-2034
[10]   Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China [J].
Huang, Chaolin ;
Wang, Yeming ;
Li, Xingwang ;
Ren, Lili ;
Zhao, Jianping ;
Hu, Yi ;
Zhang, Li ;
Fan, Guohui ;
Xu, Jiuyang ;
Gu, Xiaoying ;
Cheng, Zhenshun ;
Yu, Ting ;
Xia, Jiaan ;
Wei, Yuan ;
Wu, Wenjuan ;
Xie, Xuelei ;
Yin, Wen ;
Li, Hui ;
Liu, Min ;
Xiao, Yan ;
Gao, Hong ;
Guo, Li ;
Xie, Jungang ;
Wang, Guangfa ;
Jiang, Rongmeng ;
Gao, Zhancheng ;
Jin, Qi ;
Wang, Jianwei ;
Cao, Bin .
LANCET, 2020, 395 (10223) :497-506