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Cytokine hemoadsorption is a novel therapy used to improve outcome in critically ill patients with a dysregulated cytokine response and hemodynamic instability. Patients on extracorporeal membraneous oxygenation (ECMO) often develop severe systemic inflammatory response syndrome (SIRS). Cytokine removal using different types of hemoadsorption devices is believed to block the vicious circle of inflammation dysregulation when other basic therapeutic measures fail. To date there are very limited reports on ECMO and cytokine hemoadsorption combination therapy. The aim of this retrospective study is to evaluate feasibility and effectiveness of hemoadsorption in veno-arterial and veno-venous ECMO patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Veno-arterial ECMO patients | Patients with severe SIRS post extracorporeal cardiopulmonary resuscitation (ECPR) or accompanying cardiogenic shock who were treated with hemoadsorption. | ||
| Veno-venous ECMO patients | Patients with refractory septic shock on VV ECMO who were treated with hemoadsorption. |
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| Measure | Description | Time Frame |
|---|---|---|
| Haemodynamic stabilization | Decreased need for vasopressors according to vasoactive-inotropic score and increase in mean arterial pressure | Within 12 hours after hemoadsorption |
| Measure | Description | Time Frame |
|---|---|---|
| Lactate, interleukin-6, C-reactive protein and procalcitonin clearance | Within 12 hours after hemoadsorption | |
| Weaning from ECMO | from day of ECMO-implant for every 24 hours until date of weaning or death, whichever came first, assessed up to 90 days |
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Inclusion Criteria:
Exclusion Criteria:
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Patients on VA ECMO or VV ECMO treated with hemoadsorption
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Medical Center Ljubljana | Ljubljana | 1000 | Slovenia |
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| ID | Term |
|---|---|
| D000080424 | Cytokine Release Syndrome |
| D012770 | Shock, Cardiogenic |
| D006323 | Heart Arrest |
| D012772 | Shock, Septic |
| D012128 | Respiratory Distress Syndrome |
| ID | Term |
|---|---|
| D018746 | Systemic Inflammatory Response Syndrome |
| D007249 | Inflammation |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ICU length of stay | from day of ICU-admission for every 24 hours until date of discharge or death, whichever came first, assessed up to 90 days |
| Hospital mortality | from day of hospital admission until date of discharge or death, whichever came first, assessed up to 90 days |
| D012769 | Shock |
| D009203 | Myocardial Infarction |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D014652 | Vascular Diseases |
| D007238 | Infarction |
| D007511 | Ischemia |
| D009336 | Necrosis |
| D018805 | Sepsis |
| D007239 | Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D012120 | Respiration Disorders |