scholarly journals Cytokine Adsorption Therapy during Extracorporeal Membrane Oxygenation in Adult Patients with COVID-19

2021 ◽  
pp. 1-7
Author(s):  
Simão C. Rodeia ◽  
Francisca Lopes Martins ◽  
Philip Fortuna ◽  
Luís Bento
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Potential Role ◽  
Case Series ◽  
Blood Purification ◽  
The Body ◽  
Cytokine Release ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Membrane Oxygenation ◽  
Inflammatory State

Respiratory failure and systemic inflammation are paramount features of severe SARS-CoV-2 disease (COVID-19). Extracorporeal membrane oxygenation (ECMO) therapy has a potential role in patients with refractory disease. An inflammatory response due to blood contact with hemofilters, functioning as a synergic inflammatory stimulus, can lead to a hyperinflammatory state, relatable to cytokine release syndromes. After the first patient succumbed to a refractory vasodilatory shock believed to be due to hyperinflammatory state, a strategy of blood purification through cytokine adsorption therapy (CAT) with CytoSorb® was designed. In this case series, the authors describe the initial experience with such strategy. CAT was employed with no direct complications and helped controlling the inflammatory state, with all patients halting vasopressor support in 72 h and biomarker levels (C-reactive protein, ferritin, and interleukin-6) showing negative trends in most patients. Analysis of inflammatory biomarkers evolution highlighted 2 biomarker profiles related to the presence or absence of superinfection at the time of CAT implementation. In this case series of severe COVID-19 patients, 3 patients died – irreversible lung fibrosis, complications of critical hypoxemia before ECMO induction and complications of systemic anticoagulation were the causes. This case series aimed to contribute to the body of evidence substantiating CAT utilization in hyperinflammatory patients, namely, COVID-19 patients requiring ECMO rescue.

scholarly journals Kinetics of Procalcitonin in Pediatric Patients on Extracorporeal Membrane Oxygenation

2018 ◽  
Vol 13 ◽  
pp. 117727191775190 ◽  
Author(s):  
Sara Bobillo ◽  
Javier Rodríguez-Fanjul ◽  
Anna Solé ◽  
Julio Moreno ◽  
Mònica Balaguer ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Prospective Observational Study ◽  
Pediatric Patients ◽  
Clinical Situation ◽  
Multiple Organ ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Membrane Oxygenation ◽  
Neurologic Sequelae ◽  
Kinetics Of

Objectives: To assess the kinetics of procalcitonin (PCT) and C-reactive protein (CRP) in pediatric patients who required extracorporeal membrane oxygenation (ECMO) and to analyze its relationship with morbidity and mortality. Patients and methods: Prospective observational study including pediatric patients who required ECMO. Both PCT and CRP were sequentially drawn before ECMO (P0) and until 72 hours after ECMO. Results: A total of 40 patients were recruited. Two cohorts were established based on the value of the P0 PCT (>10 ng/mL). Comparing the kinetics of PCT and CRP in these cohorts, the described curves were the expected for each clinical situation. The cutoff for P0 PCT to predict multiple organ dysfunction syndrome was 2.55 ng/mL (sensibility 83%, specificity 100%). Both PCT and CRP did not predict risk of neurologic sequelae or mortality in any group. Conclusions: Procalcitonin does not seem to be modified by ECMO and could be a good biomarker of evolution.

scholarly journals Efficacy of Tocilizumab Therapy in Different Subtypes of COVID-19 Cytokine Storm Syndrome

Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1067
Author(s):  
Oleksandr Oliynyk ◽  
Wojciech Barg ◽  
Anna Slifirczyk ◽  
Yanina Oliynyk ◽  
Vitaliy Gurianov ◽  
...  
Keyword(s):  
Macrophage Activation Syndrome ◽  
Macrophage Activation ◽  
Cytokine Storm ◽  
Cytokine Release ◽  
Cytokine Release Syndrome ◽  
C Reactive Protein ◽  
Treatment Results ◽  
Reactive Protein ◽  
Median Serum ◽  
D Dimer

Background: Cytokine storm in COVID-19 is heterogenous. There are at least three subtypes: cytokine release syndrome (CRS), macrophage activation syndrome (MAS), and sepsis. Methods: A retrospective study comprising 276 patients with SARS-CoV-2 pneumonia. All patients were tested for ferritin, interleukin-6, D-Dimer, fibrinogen, calcitonin, and C-reactive protein. According to the diagnostic criteria, three groups of patients with different subtypes of cytokine storm syndrome were identified: MAS, CRS or sepsis. In the MAS and CRS groups, treatment results were assessed depending on whether or not tocilizumab was used. Results: MAS was diagnosed in 9.1% of the patients examined, CRS in 81.8%, and sepsis in 9.1%. Median serum ferritin in patients with MAS was significantly higher (5894 vs. 984 vs. 957 ng/mL, p < 0.001) than in those with CRS or sepsis. Hypofibrinogenemia and pancytopenia were also observed in MAS patients. In CRS patients, a higher mortality rate was observed among those who received tocilizumab, 21 vs. 10 patients (p = 0.043), RR = 2.1 (95% CI 1.0–4.3). In MAS patients, tocilizumab decreased the mortality, 13 vs. 6 patients (p = 0.013), RR = 0.50 (95% CI 0.25–0.99). Сonclusions: Tocilizumab therapy in patients with COVID-19 and CRS was associated with increased mortality, while in MAS patients, it contributed to reduced mortality.

Psychiatric Outcome after Severe Cardio-Respiratory Failure Treated with Extracorporeal Membrane Oxygenation: A Case-Series

2013 ◽  
Vol 54 (5) ◽  
pp. 418-427 ◽  
Author(s):  
Ivar Risnes ◽  
Aasta Heldal ◽  
Kari Wagner ◽  
Birgitte Boye ◽  
Ira Haraldsen ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Case Series ◽  
Membrane Oxygenation ◽  
Psychiatric Outcome

scholarly journals Anticipation of High-Sensitivity C-Reactive Protein Effect on Post Myocardial Infarction Depression Disorder

2021 ◽  
Vol 10 ◽  
pp. e1512
Author(s):  
Parichehr Alizadeh ◽  
Ehsan Bahramali ◽  
Arvin Hedayati ◽  
Azizallah Dehghan
Keyword(s):  
Myocardial Infarction ◽  
High Sensitivity ◽  
Intima Media Thickness ◽  
Public Health Issue ◽  
C Reactive Protein ◽  
Mild Depression ◽  
Reactive Protein ◽  
Depressed Patients ◽  
Inflammatory State ◽  
Hs Crp

Background: The natural history of acute myocardial infarction (AMI) as the most prevalent public health issue in Iran has changed with the introduction of novel therapeutic strategies that have reduced its mortality significantly. Major depressive disorder (MDD) is a prevalent and disabling psychiatric disorder and frequently co-exist with AMI. There are proposed pathophysiological links between the two diseases among which inflammation is the most important. With more patients surviving a myocardial infarction (MI) event, post-MI depression has become an important determinant of disability and mortality. Materials and Methods: In this study we defined a 1-month post-MI depressive scale of 200 patients using Beck’s inventory questionnaire II and measured serum high Sensitivity C-Reactive Protein (hs-CRP) and carotid intima-media thickness (CIMT) to look for the association between inflammatory state and atherosclerosis in different depression score categories. Results: Minimum and maximum Beck scores were 1 and 43, respectively with a mean of 13±8. The mean CIMT was 0.77±0.26 mm. Serum hs-CRP level was measured with a mean of 1.51±1.6 mg/L. According to BDI-II scores, 44.2% of patients 1-month post-MI suffered from more than mild depression. Being affected was not correlated with either the level of hs-CRP or CIMT. Nearly 44 percent of patients suffered more than mild depression. There was a negative association between serum hs-CRP level and CIMT as a measure of atherosclerosis in groups of depressed versus non-depressed patients. This may indicate that the extent of atherosclerosis is not correlated with the inflammatory state after MI in depressed versus non-depressed patients. Conclusions: The results of this study indicate that the extent of atherosclerosis is not correlated with the inflammatory state after MI in depressed versus non-depressed patients. Nonetheless, the prognostic indications of increased hs-CRP and depression after AMI remains to be investigated further. [GMJ.2021;10:e1512]

scholarly journals Dietary Fiber's Effect on High Sensitivity C-reactive Protein Serum in Sedentary Workers

2021 ◽  
Vol 5 (1) ◽  
pp. 40
Author(s):  
Livia Kurniati Saputra ◽  
Dian Novita Chandra ◽  
Ninik Mudjihartini
Keyword(s):  
Body Weight ◽  
High Sensitivity ◽  
The Body ◽  
Low Grade ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Dietary Fiber Intake ◽  
Anti Inflammatory ◽  
Low Grade Inflammation ◽  
Inflammatory Effect

Low grade inflammation has been recognized of being involved in the pathogenesis of chronic disease pandemic. Individual lifestyle plays a major role in the development of low grade inflammation. Sedentary workers are at risk of low grade inflammation due to the nature of their work. Dietary habit also contributes to inflammatory status in the body. Dietary fiber intake indirectly affects the immune system. It has been hypothesized that fiber has anti-inflammatory effects, both body weight-related and body weight-unrelated This review will focus more on body weight-unrelated anti-inflammatory effect of fiber, especially through fiber’s fermentation metabolites, the short chain fatty acid (SCFA). Its anti-inflammatory effect can be seen by monitoring a biomarker of inflammation in the body, the high sensitivity C-reactive protein (hsCRP). This review’s objective is to cover the mechanisms and role of dietary fiber intake on serum hsCRP level as a marker of low grade inflammation on sedentary workers. 

scholarly journals Correlation of Ferritin and Transferrin Serum with hsCRP and F2-Isoprostane in Metabolic Syndrome

2010 ◽  
Vol 2 (3) ◽  
pp. 131
Author(s):  
Waode Nurfina ◽  
Irawan Yusuf ◽  
Mansyur Arif
Keyword(s):  
Oxidative Stress ◽  
Metabolic Syndrome ◽  
Iron Status ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
The Metabolic Syndrome ◽  
Metabolic Conditions ◽  
Inflammatory State ◽  
And Oxidative Stress

BACKGROUND: The low inflammatory state that accompanies the Metabolic Syndrome (MetS) associates with the overexpression of oxidative stress. Ferritin and Transferrin serum are often used to measure iron status and their concentrations are altered in several metabolic conditions. We hypothesized that concentration of Ferritin and Transferrin serum increase in Metabolic Syndrome (MetS) and correlate with the inflammation and oxidative stress.METHODS: We studied 65 male MetS patients, aged 43.26±7.16 years. Iron metabolism was measured by concentration of Ferritin and Transferrin serums, while inflammatory and oxidative stress by high sensitivity C-reactive Protein (hsCRP) and F2-Isoprostane.RESULTS: Concentration of Ferritin 315.70±188.63 ng/L and Transferrin 2.36±0.31 g/L increased along with increasing components of MetS. Concentration of Ferritin serum had a positive correlation with hsCRP (r=0.220) and F2-Isoprostane (r=0.023).CONCLUSION: Serum concentration of Ferritin increased in the MetS and correlates with hsCRP and F2-Isoprostane.KEYWORDS: metabolic syndrome, ferritin, transferrin, hsCRP, F2-isoprostane

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