scholarly journals Medium Cut-Off Dialysis Membranes: Can They Have Impact on Outcome of COVID-19 Hemodialysis Patients?

2021 ◽  
pp. 1-4
Author(s):  
Serkan Feyyaz Yalın ◽  
Mehmet Rıza Altıparmak ◽  
Mevlut Tamer Dincer ◽  
Serap Yadigar ◽  
Ahmet Murt ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Medical Records ◽  
Severe Disease ◽  
Hemodialysis Patients ◽  
Cytokine Storm ◽  
Severity Of Disease ◽  
Middle Molecules ◽  
Cytokine Levels ◽  
Dialysis Membranes ◽  
The Impact

<b><i>Introduction:</i></b> Severe acute respiratory syndrome coronavirus-2 may lead to high levels of expression of inflammatory cytokines. Medium cut-off (MCO) membranes may make greater clearances for large-middle molecules (including cytokines) than low-flux (LF) membranes. In this study, we aimed to evaluate the impact of MCO membranes on outcome of COVID-19 patients on hemodialysis (HD). <b><i>Methods:</i></b> Sixty COVID-19 HD patients were included in this study. The patients were categorized into 2 groups regarding type of HD membranes. Clinical data were taken from medical records. <b><i>Results:</i></b> Initial crp and ferritin levels, which are surragates of cytokine storm and severity of disease in COVID-19, were significantly higher in MCO membrane group compared to LF group (<i>p</i> = 0.037 and 0.000, respectively). Although there were more patients with severe disease in MCO group, there were no significant differences regarding need for intensive care unit and death. <b><i>Conclusion:</i></b> It may be an option to use MCO membranes in HD patients with COVID-19 in order to reduce cytokine levels and prevent cytokine storm.

scholarly journals May Medium Cut-Off Dialysis Membranes Have Impact on Outcome of COVID-19 Hemodialysis Patients?

2020 ◽  
Author(s):  
SERKAN FEYYAZ YALIN ◽  
AHMET MURT ◽  
MEVLUT TAMER DINCER ◽  
ERGUN PARMAKSIZ ◽  
SERAP YADIGAR ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Inflammatory Cytokines ◽  
Medical Records ◽  
Kidney Diseases ◽  
Hemodialysis Patients ◽  
Cytokine Storm ◽  
Radiologic Findings ◽  
Middle Molecules ◽  
Cytokine Levels ◽  
Dialysis Membranes

Abstract Purpose: Severe acute respiratory syndrome coronavirus 2 which is a novel type of coronavirus, may lead to high levels of expression of inflammatory cytokines. Medium cut-off membranes may make greater clearances for large-middle molecules (including cytokines) than low flux membranes. In this study, we aimed to evaluate impact of type of hemodialysis membranes on outcome of COVID 19+ hemodialysis patients.Methods: Forty nine COVID 19 + hemodialysis patients were included into study. The patients were categorized into two groups regarding type of hemodialysis membranes. Clinical data, etiologies of kidney diseases, comorbidities, laboratory and radiologic findings, antiviral, anti-cytokine treatments, and hemodialysis data were taken from medical records. Results: Medium cut-off membranes were used in 15 patients and low flux membranes were used in 34 patients. There were significantly more patients with comorbidities in medium cut-off group compare to low flux group (p=0,014). CRP and ferritin which are each surragates of cytokine storm in COVID-19, were significantly higher in medium cut-off membrane group compare to low flux group (p=0,00, 0,01, respectively).Conclusion: It may be an option to use medium cut-off membranes in hemodialysis patients with COVID 19 in order to reduce cytokine levels and prevent cytokine storm.

scholarly journals Coronavirus Disease 2019 (COVID-19) and Nutritional Status: The Missing Link?

2020 ◽  
Author(s):  
Renata Silverio ◽  
Daniela Caetano Gonçalves ◽  
Márcia Fábia Andrade ◽  
Marilia Seelaender
Keyword(s):  
Body Composition ◽  
Immune System ◽  
Nutritional Status ◽  
Immune Responses ◽  
Lean Mass ◽  
Severe Disease ◽  
Cytokine Storm ◽  
Risk Of Infection ◽  
Elderly Individuals ◽  
The Impact

ABSTRACT Coronavirus disease 2019 (COVID-19) is an emerging disease that has reached pandemic status by rapidly spreading worldwide. Elderly individuals and patients with comorbidities such as obesity, diabetes, and hypertension show a higher risk of hospitalization, severe disease, and mortality by acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. These patients frequently show exacerbated secretion of proinflammatory cytokines associated with an overreaction of the immune system, the so-called cytokine storm. Host nutritional status plays a pivotal role in the outcome of a variety of different infectious diseases. It is known that the immune system is highly affected by malnutrition, leading to decreased immune responses with consequent augmented risk of infection and disease severity. Body composition, especially low lean mass and high adiposity, has consistently been linked to worsened prognosis in many different diseases. In this review, evidence concerning the impact of nutritional status on viral infection outcomes is discussed.

scholarly journals The Relationship between Gender, Severity of Disease, Treatment Type, and Employment Outcome in Patients with Inflammatory Bowel Disease in Israel

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Timna Naftali ◽  
Adi Eindor-Abarbanel ◽  
Nahum Ruhimovich ◽  
Ariella Bar-Gil Shitrit ◽  
Fabiana Sklerovsky-Benjaminov ◽  
...  
Keyword(s):  
Employment Status ◽  
Demographic Data ◽  
Severe Disease ◽  
Working Hours ◽  
Full Time ◽  
Biologic Treatment ◽  
Severity Of Disease ◽  
Treatment Type ◽  
Employment Rates ◽  
The Impact

Introduction. Since individuals with IBD typically experience symptoms during their prime years of employment, it raises the question about IBD impact on employment status. Most studies concentrated on absenteeism from work with varying results in different populations. However, absenteeism reflects only one dimension of the ability to work and does not expose the problem of inability to hold a full-time job. Aims. To evaluate the influence of IBD on unemployment and working hours in Israel. Secondary aims were to investigate the correlation between working hours and the type of medical treatment and the impact of severity of disease. Patients and Methods. Demographic data, employment status, number of weekly working hours, and disease parameters. The data was compared to that of the general Israeli population extracted from the website of the Central Bureau of Statistics. Results. 242 IBD patients were interviewed. Patients median age was 37.04(IQR 30.23-44.68) years and 88 (36.4%) were men and 154 (63.6%) women. Diagnosis of CD was established in 167 (69%) patients and UC in 65 (26.9%). There was no significant reduction in employment rates or working hours among the IBD patients comparing to the general population. Immunosuppressive or biologic treatment did not influence employment status. The unemployed patients had higher disease severity (median 7.33, IQR 5-10.66) compared to employed patients (median 6, IQR 3.66-7.66; p=0.003). Conclusions. Although IBD patients in Israel do not have higher unemployment, those with severe disease have lower proportion of employment.

scholarly journals Impacto da oferta proteica calórica em pacientes cardíacos críticos em nutrição enteral

2020 ◽  
Vol 34 (4) ◽  
pp. 402-407
Author(s):  
Renata Monteiro Vieira ◽  
Sandra Mari Barbiero ◽  
Soraia Poloni ◽  
Silvia Regina Rios Vieira
Keyword(s):  
Intensive Care Unit ◽  
Length Of Stay ◽  
Medical Records ◽  
Retrospective Cohort ◽  
Icu Mortality ◽  
Cardiac Intensive Care Unit ◽  
Adequate Diet ◽  
Icu Length Of Stay ◽  
Cardiac Intensive Care ◽  
The Impact

Objective: The purpose of this study is to verify the impact of protein and calorie deficit with length of stay mechanical ventilation (MV) time, and death in critically ill patients in enteral nutrition (EN). Methods: Retrospective cohort study. Patients older than, 18 years, hospitalized in a cardiac intensive care unit (ICU), on exclusive EN were included. Data regarding daily infusion values of EN on the 5th and 10th day, beginning and maintenance of EN, hospital and ICU length of stay, and MV maintenance were collected in medical records. Results: A total of 155 patients were included, 61% male, mean age 73.23 ± 11.9 years; death within 30 days was 36.4%. Caloric adequacy on the 5th and 10th day was 52.45% and 62.71%, respectively; protein received in 10 days was 0.84 ± 0.29 g/kg/d. Those receiving less than 70% of the EN prescribed died 1.4 times more. Conclusion: Our findings suggest that receiving adequate diet reduces ICU mortality in cardiac patients.

scholarly journals The Role of Hemoperfusion in COVID-19 Infection: A Case Series

2021 ◽  
Author(s):  
Ali Amirsavadkouhi ◽  
Alireza Jahangirifard ◽  
Reza Shahrami ◽  
Saeid Safari ◽  
Faezeh Feizabadi ◽  
...  
Keyword(s):  
Medical Records ◽  
Medical Condition ◽  
Case Series ◽  
Severe Infection ◽  
Multiple Organ ◽  
Pathological Process ◽  
Rapid Expansion ◽  
Cytokine Storm ◽  
Cytokine Levels

The rapid expansion of a novel human infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has evolved into a pandemic, affecting thousands of people world wild. Some patients with coronavirus disease 2019 (COVID-19) develop severe infection, which may progress to acute respiratory distress syndrome, multiple organ failure, and death. Increasing studies indicate that abnormal elevation of cytokine levels in response to SARS-CoV-2 may contribute to the pathological process that leads mortality of COVID-19. Thus, application of extracorporeal hemoperfusion (HP) for removal of excessive cytokines from the blood can potentially mitigate or reverse cytokine storm related complications of COVID-19. Here, we presented series of COVID-19 patients, who were treated with HP (HA 380 cartridge, Jafron Biomedocal Co, China). The medical records were evaluated retrospectively to determine the effect of HP on patients’ clinical outcome. Our results showed that HP improvee PO2 and O2 saturation in patients with severe COVID-19. After the last courses of HP, 5 out of 6 patients were extubated and transferred to the general ward with an acceptable medical condition. The following case series demonstrate the promising role of HP in controlling the consequential effect of cytokine storm following a COVID-19 infection, which could facilitate patient survival.

Differential impact of on-site or telepharmacy in the intensive care unit: a controlled before–after study

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Joao Gabriel Rosa Ramos ◽  
Sandra Cristina Hernandes ◽  
Talita Teles Teixeira Pereira ◽  
Shana Oliveira ◽  
Denis de Melo Soares ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Phase 1 ◽  
Phase 2 ◽  
Differential Impact ◽  
Scarce Resources ◽  
Clinical Pharmacists ◽  
Versus Phase ◽  
Quasi Experimental ◽  
The Impact

Abstract Background Clinical pharmacists have an important role in the intensive care unit (ICU) team but are scarce resources. Our aim was to evaluate the impact of on-site pharmacists on medical prescriptions in the ICU. Methods This is a retrospective, quasi-experimental, controlled before-after study in two ICUs. Interventions by pharmacists were evaluated in phase 1 (February to November 2016) and phase 2 (February to May 2017) in ICU A (intervention) and ICU B (control). In phase 1, both ICUs had a telepharmacy service in which medical prescriptions were evaluated and interventions were made remotely. In phase 2, an on-site pharmacist was implemented in ICU A, but not in ICU B. We compared the number of interventions that were accepted in phase 1 versus phase 2. Results During the study period, 8797/9603 (91.6%) prescriptions were evaluated, and 935 (10.6%) needed intervention. In phase 2, there was an increase in the proportion of interventions that were accepted by the physician in comparison to phase 1 (93.9% versus 76.8%, P &lt; 0.001) in ICU A, but there was no change in ICU B (75.2% versus 73.9%, P = 0.845). Conclusion An on-site pharmacist in the ICU was associated with an increase in the proportion of interventions that were accepted by physicians.

scholarly journals SARS-CoV-2 and Cytomegalovirus Co-Infections—A Case Series of Critically Ill Patients

2021 ◽  
Vol 10 (13) ◽  
pp. 2792
Author(s):  
Patrícia Moniz ◽  
Sérgio Brito ◽  
Pedro Póvoa
Keyword(s):  
Intensive Care Unit ◽  
Critically Ill ◽  
Immune Suppression ◽  
Clinical Course ◽  
Health Care Systems ◽  
Case Series ◽  
Confounding Factors ◽  
Care Systems ◽  
The Impact ◽  
Cmv Reactivation

The SARS-CoV-2 pandemic has placed great strain on the most developed of health care systems, especially in the context of critical care. Although co-infections with cytomegalovirus (CMV) are frequent in the critically ill due to underlying immune suppression of multiple causes, the impact on COVID-19 patients remains unclear. Furthermore, severe COVID-19 has recently been associated with significant immune suppression, and this may in turn impact CMV reactivation, possibly contributing to clinical course. Nevertheless, multiple confounding factors in these patients will certainly challenge upcoming research. The authors present a case series of five patients admitted to the intensive care unit (ICU) in the context of respiratory failure due to severe COVID-19. All patients evolved with CMV reactivation during ICU stay.

The presence of liver cirrhosis is a strong negative predictor of survival for patients admitted to the intensive care unit – Cirrhosis in intensive care patients

2021 ◽  
Author(s):  
Jörg Bojunga ◽  
Mireen Friedrich-Rust ◽  
Alica Kubesch ◽  
Kai Henrik Peiffer ◽  
Hannes Abramowski ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Liver Cirrhosis ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Intensive Care Treatment ◽  
Matched Cohort ◽  
Care Treatment ◽  
Cirrhotic Patients ◽  
The Impact ◽  
Cirrhotic Group

Abstract Background and Aims Liver cirrhosis is a systemic disease that substantially impacts the body’s physiology, especially in advanced stages. Accordingly, the outcome of patients with cirrhosis requiring intensive care treatment is poor. We aimed to analyze the impact of cirrhosis on mortality of intensive care unit (ICU) patients compared to other frequent chronic diseases and conditions. Methods In this retrospective study, patients admitted over three years to the ICU of the Department of Medicine of the University Hospital Frankfurt were included. Patients were matched for age, gender, pre-existing conditions, simplified acute physiology score (SAPS II), and therapeutic intervention scoring system (TISS). Results A total of 567 patients admitted to the ICU were included in the study; 99 (17.5 %) patients had liver cirrhosis. A total of 129 patients were included in the matched cohort for the sensitivity analysis. In-hospital mortality was higher in cirrhotic patients than non-cirrhotic patients (p < 0.0001) in the entire and matched cohort. Liver cirrhosis remained one of the strongest independent predictors of in-hospital mortality (entire cohort p = 0.001; matched cohort p = 0.03) along with dialysis and need for transfusion in the multivariate logistic regression analysis. Furthermore, in the cirrhotic group, the need for kidney replacement therapy (p < 0.001) and blood transfusion (p < 0.001) was significantly higher than in the non-cirrhotic group.  Conclusions In the presented study, liver cirrhosis was one of the strongest predictors of in-hospital mortality in patients needing intensive care treatment along with dialysis and the need for ventilation. Therefore, concerted efforts are needed to improve cirrhotic patients’ outcomes, prevent disease progression, and avoid complications with the need for ICU treatment in the early stages of the disease.

scholarly journals Splanchnic Vein Thrombosis in Acute Pancreatitis and Its Consequences

2021 ◽  
Vol 27 ◽  
pp. 107602962110102
Author(s):  
Łukasz Nawacki ◽  
Jarosław Matykiewicz ◽  
Ewa Stochmal ◽  
Stanisław Głuszek
Keyword(s):  
Acute Pancreatitis ◽  
Severe Disease ◽  
Vascular Complication ◽  
Strong Positive Correlation ◽  
Splanchnic Vein Thrombosis ◽  
Vein Thrombosis ◽  
Computed Tomography Scans ◽  
Negative Effect ◽  
Medical Histories ◽  
The Impact

Splanchnic vein thrombosis (SVT) is a serious vascular complication that can occur in patients with acute pancreatitis. We assessed the incidence of SVT and its relationship with acute pancreatitis (AP) and associated complications. We carried out a retrospective analysis of medical histories from patients hospitalized with AP in a single surgical center. Histories were acquired from patients with abdominal and pelvic computed tomography scans performed between the 2nd and 3rd day of hospitalization. We assessed the impact and extent of thrombosis over the disease course. We found a strong positive correlation (Cramer’s V coefficient = 0.34) between SVT and disease severity. Mortality in the study group was 7.2% (8 patients) of which 5 patients (62.5%) were diagnosed with SVT. We observed an increased incidence of death among patients with thrombosis, with results approaching significance ( P = 0.056). In our study, we found that SVT has a negative effect on the course of AP and is associated with more severe disease and increased mortality.

Sign in / Sign up

Export Citation Format

Share Document