دورية
أعرض في EDS

Extracorporeal CO2Removal During Renal Replacement Therapy to Allow Lung-Protective Ventilation in Patients With COVID-19–Associated Acute Respiratory Distress Syndrome

التفاصيل البيبلوغرافية
العنوان: Extracorporeal CO2Removal During Renal Replacement Therapy to Allow Lung-Protective Ventilation in Patients With COVID-19–Associated Acute Respiratory Distress Syndrome
المؤلفون: Alessandri, Francesco, Tonetti, Tommaso, Pistidda, Laura, Busani, Stefano, Borrazzo, Cristian, Fanelli, Vito, Polzoni, Mauro, Piazza, Ornella, Lorini, Luca, Cattaneo, Sergio, Ricci, Davide, Zanoni, Andrea, Girardis, Massimo, Terragni, Pierpaolo, Tempesta, Michele, Di Luca, Marina, Pugliese, Francesco, Ranieri, V. Marco, Aldegheri, Giorgio, Alessandri, Francesco, Bernd, Claus, Borrazzo, Cristian, Brivio, Matteo, Busani, Stefano, Catorze, Nuno, Cattaneo, Sergio, Corcione, Antonio, Dall’Ara, Lorenzo, Dauri, Mario, Di Luca, Marina, Fanelli, Vito, Fumagalli, Roberto, Gianni, Giulia, Giordano, Giovanni, Girardis, Massimo, Grasso, Salvatore, Grazioli, Lorenzo, Novelli, Martina, Lamas, Tomás, Lorini, Luca, Margola, Alessio, Palumbo, Roberto, Piazza, Ornella, Piazzolla, Mario, Pistidda, Laura, Pistolesi, Valentina, Polzoni, Mauro, Possick, Valeria, Pugliese, Francesco, Ribeiro, Inês, Ricci, Davide, Ranieri, V. Marco, Oliveira, Filipa, Storti, Enrico, Salaris, Davide, Terragni, Pierpaolo, Tonetti, Tommaso, Winding, Robert Ravholt, Tempesta, Michele, Urbino, Rosario, Zanoni, Andrea
المصدر: ASAIO Journal: A Peer-Reviewed Journal of the American Society for Artificial Internal Organs; January 2023, Vol. 69 Issue: 1 p36-42, 7p
مستخلص: The aim of this retrospective multicenter observational study is to test the feasibility and safety of a combined extracorporeal CO2removal (ECCO2R) plus renal replacement therapy (RRT) system to use an ultraprotective ventilator setting while maintaining (1) an effective support of renal function and (2) values of pH within the physiologic limits in a cohort of coronavirus infectious disease 2019 (COVID-19) patients. Among COVID-19 patients admitted to the intensive care unit of 9 participating hospitals, 27 patients with acute respiratory distress syndrome (ARDS) and acute kidney injury (AKI) requiring invasive mechanical ventilation undergoing ECCO2R-plus-RRT treatment were included in the analysis. The treatment allowed to reduce VTfrom 6.0 ± 0.6 mL/kg at baseline to 4.8 ± 0.8, 4.6 ± 1.0, and 4.3 ± 0.3 mL/kg, driving pressure (ΔP) from 19.8 ± 2.5 cm H2O to 14.8 ± 3.6, 14.38 ± 4.1 and 10.2 ± 1.6 cm H2O after 24 hours, 48 hours, and at discontinuation of ECCO2R-plus-RRT (T3), respectively (p< 0.001). PaCO2and pH remained stable. Plasma creatinine decreased over the study period from 3.30 ± 1.27 to 1.90 ± 1.30 and 1.27 ± 0.90 mg/dL after 24 and 48 hours of treatment, respectively (p< 0.01). No patient-related events associated with the extracorporeal system were reported. These data show that in patients with COVID-19–induced ARDS and AKI, ECCO2R-plus-RRT is effective in allowing ultraprotective ventilator settings while maintaining an effective support of renal function and values of pH within physiologic limits.
قاعدة البيانات: Supplemental Index
الوصف
تدمد:10582916
1538943X
DOI:10.1097/MAT.0000000000001803