BACKGROUND Hemoperfusion(HP)is an extracorporeal blood purification modality utilized to remove small-to medium-sized molecules,such as toxins and cytokines,that are difficult to remove by conventional hemodialysis.In...BACKGROUND Hemoperfusion(HP)is an extracorporeal blood purification modality utilized to remove small-to medium-sized molecules,such as toxins and cytokines,that are difficult to remove by conventional hemodialysis.In clinical practice,HP has been successfully used as a salvage therapy for drug overdose and occasionally in patients with liver failure and sepsis.AIM To summarize the clinical outcomes of a series of patients with severe coronavirus disease 2019(COVID-19)who received HP.METHODS Here,we summarize the clinical outcomes of a series of 18 patients with severe COVID-19 who received HP in our institution during the COVID-19 pandemic.A review of the literature was also performed.RESULTS HP was well-tolerated,and after an average of three sessions,respiratory and cardiovascular parameters as well as blood inflammatory markers improved in most patients.Ten patients were discharged alive.Our literature search identified a total of 20 studies(873 patients)in which HP was used for COVID-19.Nine studies reported improvements in respiratory parameters,and 13 studies(438 patients in total)reported better survival rates in patients undergoing HP.CONCLUSION HP was well-tolerated in patients with severe COVID-19,and most studies reported improved clinical parameters,including better survival rates,when HP was used in patients with severe COVID-19.Further research,especially prospective studies,is needed to evaluate the utility of HP as an early and supportive therapy for critically ill patients due to infectious diseases,such as those with COVID-19 or severe sepsis.展开更多
目的通过Meta分析评价血液灌流联合血液滤过对脓毒症炎症介质及预后的影响。方法检索PubMed、Web of Science、Medline、中国知网(CNKI)、万方数据库、维普数据库,选取血液灌流联合血液滤过对脓毒症治疗的随机对照试验(观察组采用血液...目的通过Meta分析评价血液灌流联合血液滤过对脓毒症炎症介质及预后的影响。方法检索PubMed、Web of Science、Medline、中国知网(CNKI)、万方数据库、维普数据库,选取血液灌流联合血液滤过对脓毒症治疗的随机对照试验(观察组采用血液灌流联合血液滤过治疗,对照组采用单纯血液滤过治疗),检索时间为建库至2023年6月30日。采用RevMan 5.4软件进行Meta分析,采用漏斗图进行偏倚评估。结果共纳入19篇文献,1322例患者。Meta分析结果显示:观察组与对照组患者相比C反应蛋白降低(SMD=-1.60,95%CI:-2.02~-1.18,P<0.001)、肿瘤坏死因子-α水平下降(SMD=-1.60,95%CI:-1.77~-1.43,P<0.001)、白细胞介素-6水平下降(SMD=-1.29,95%CI:-1.43~-1.14,P<0.001)、序贯器官衰竭评分降低(SMD=-0.74,95%CI:-0.98~-0.51,P<0.001)、病死率降低(RR=0.50,95%CI:0.39~0.65,P<0.001)。结论血液灌流联合血液滤过治疗可以下调脓毒症的炎症介质,降低序贯器官衰竭评分及病死率,改善预后。展开更多
文摘BACKGROUND Hemoperfusion(HP)is an extracorporeal blood purification modality utilized to remove small-to medium-sized molecules,such as toxins and cytokines,that are difficult to remove by conventional hemodialysis.In clinical practice,HP has been successfully used as a salvage therapy for drug overdose and occasionally in patients with liver failure and sepsis.AIM To summarize the clinical outcomes of a series of patients with severe coronavirus disease 2019(COVID-19)who received HP.METHODS Here,we summarize the clinical outcomes of a series of 18 patients with severe COVID-19 who received HP in our institution during the COVID-19 pandemic.A review of the literature was also performed.RESULTS HP was well-tolerated,and after an average of three sessions,respiratory and cardiovascular parameters as well as blood inflammatory markers improved in most patients.Ten patients were discharged alive.Our literature search identified a total of 20 studies(873 patients)in which HP was used for COVID-19.Nine studies reported improvements in respiratory parameters,and 13 studies(438 patients in total)reported better survival rates in patients undergoing HP.CONCLUSION HP was well-tolerated in patients with severe COVID-19,and most studies reported improved clinical parameters,including better survival rates,when HP was used in patients with severe COVID-19.Further research,especially prospective studies,is needed to evaluate the utility of HP as an early and supportive therapy for critically ill patients due to infectious diseases,such as those with COVID-19 or severe sepsis.
文摘目的通过Meta分析评价血液灌流联合血液滤过对脓毒症炎症介质及预后的影响。方法检索PubMed、Web of Science、Medline、中国知网(CNKI)、万方数据库、维普数据库,选取血液灌流联合血液滤过对脓毒症治疗的随机对照试验(观察组采用血液灌流联合血液滤过治疗,对照组采用单纯血液滤过治疗),检索时间为建库至2023年6月30日。采用RevMan 5.4软件进行Meta分析,采用漏斗图进行偏倚评估。结果共纳入19篇文献,1322例患者。Meta分析结果显示:观察组与对照组患者相比C反应蛋白降低(SMD=-1.60,95%CI:-2.02~-1.18,P<0.001)、肿瘤坏死因子-α水平下降(SMD=-1.60,95%CI:-1.77~-1.43,P<0.001)、白细胞介素-6水平下降(SMD=-1.29,95%CI:-1.43~-1.14,P<0.001)、序贯器官衰竭评分降低(SMD=-0.74,95%CI:-0.98~-0.51,P<0.001)、病死率降低(RR=0.50,95%CI:0.39~0.65,P<0.001)。结论血液灌流联合血液滤过治疗可以下调脓毒症的炎症介质,降低序贯器官衰竭评分及病死率,改善预后。
