Subarachnoid Hemorrhage and Extracorporeal Blood Purification with HA-380 and High-Volume Hemofiltration: A New Therapeutic Challenge at the Neurocritical Care Unit? A Case Report

2021 ◽  
pp. 1-4
Author(s):  
Gonzalo Ramírez-Guerrero ◽  
Rocio Oliva Alarcón ◽  
Francisco Villagrán Cortés ◽  
Vicente Torres Cifuentes ◽  
Romyna Baghetti Hernández ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Neurocritical Care ◽  
High Volume ◽  
Refractory Shock ◽  
Source Of Infection ◽  
Extracorporeal Blood Purification ◽  
Hemodynamic Deterioration ◽  
Management Of Complications ◽  
High Volume Hemofiltration ◽  
High Doses

We present the case of a patient with subarachnoid hemorrhage (SAH) secondary to a ruptured cerebral aneurysm and a refractory shock with high doses of vasopressors without a proven source of infection. This patient received therapy with high-volume hemofiltration plus adsorption, resolving the hemodynamic deterioration and with good neurological evolution. Our clinical case proposes that extracorporeal therapies may have a feasibility role in the management of complications of SAH.

High-Volume Hemofiltration as Adjuvant Therapy for Refractory Shock after Pericardiocentesis

2011 ◽  
Vol 14 (5) ◽  
pp. 313
Author(s):  
Romuald Lango ◽  
Maciej M. Kowalik ◽  
Piotr Siondalski ◽  
Jan Rogowski ◽  
Alicja Dabrowska-Kugacka
Keyword(s):  
Cardiac Tamponade ◽  
Inflammatory Mediators ◽  
Experimental Studies ◽  
High Volume ◽  
Left Ventricular ◽  
Sudden Increase ◽  
Refractory Shock ◽  
Hemodynamic Deterioration ◽  
High Volume Hemofiltration ◽  
Hemodynamic Improvement

<p><b>Background:</b> Pericardiocentesis for the treatment of chronic cardiac tamponade can occasionally result in acute pulmonary edema or biventricular failure. A sudden increase in heart filling pressures and right-to-left ventricular-output mismatch have been proposed underlying mechanisms.</p><p><b>Case Report:</b> We report the case of 16-year-old patient who underwent pericardiocentesis for chronic cardiac tamponade 6 weeks after undergoing a Bentall procedure. The patient developed circulatory shock 6 hours after pericardiocentesis. High-volume hemofiltration was used as a rescue therapy after treatment with positive inotropic drugs proved ineffective. An improvement in circulatory function observed after commencement of the hemofiltration treatment was followed by hemodynamic deterioration when the hemofiltration procedure was ceased.</p><p><b>Discussion:</b> The mechanism of the observed hemodynamic improvement is unclear. Hemodynamic recovery related in time to high-volume hemofiltration treatment indicates the possible removal of inflammatory mediators. Visceral vasoconstriction resulting from cardiac tamponade and subsequent improvement in gut perfusion after pericardiocentesis that led to washout of inflammatory mediators might have contributed to the development of acute heart failure. Cytokine removal by high-volume hemofiltration and the procedure's relationship to hemodynamic improvement have previously been demonstrated in clinical and experimental studies of septic shock.</p><p><b>Conclusions:</b> We conclude that high-volume hemofiltration can be helpful as an adjuvant treatment for refractory shock after pericardiocentesis for chronic cardiac tamponade. The mechanism of the observed hemodynamic improvement remains to be investigated.</p>

scholarly journals What Have We Learned about the Use of Cytosorb Adsorption Columns?

2019 ◽  
Vol 48 (3) ◽  
pp. 196-202 ◽  
Author(s):  
Ghada Ankawi ◽  
Yun Xie ◽  
Bo Yang ◽  
Yuanyuan Xie ◽  
Pan Xie ◽  
...  
Keyword(s):  
Renal Replacement Therapy ◽  
Treatment Strategies ◽  
High Volume ◽  
Blood Purification ◽  
Quality Level ◽  
Level Of Evidence ◽  
Extracorporeal Blood Purification ◽  
Plasma Filtration ◽  
High Volume Hemofiltration ◽  
Novel Applications

Extracorporeal blood purification techniques have emerged and evolved in the recent years as a potential therapy for the purpose of immunomodulation in acute conditions like sepsis. Understanding the extent of immune system dysregulation involved in the pathophysiology of these conditions, resulted in the development of such treatment strategies aiming at restoring a balanced inflammatory response. Beyond conventional continuous renal replacement therapy, high volume hemofiltration, high cut-off membranes, adsorption alone and coupled plasma filtration adsorption are well-described techniques in the literature. The evidence to support their routine use, however, is conflicting and insufficient at this stage. Despite the low-quality level of evidence in favor of utilizing these techniques, studies to further explore their effectiveness, safety, and potential novel applications, continue to evolve. Our review aims at focusing on adsorption therapy, particularly using the adsorption columns Cystosorb.

Extracorporeal Blood Treatment (EBT) Methods in SIRS/Sepsis

2005 ◽  
Vol 28 (5) ◽  
pp. 450-458 ◽  
Author(s):  
R. Bellomo ◽  
P. Honoré ◽  
J. Matson ◽  
C. Ronco ◽  
J. Winchester
Keyword(s):  
High Volume ◽  
Future Research ◽  
Technical Management ◽  
Extracorporeal Blood ◽  
Future Research Agenda ◽  
Extracorporeal Blood Purification ◽  
Consensus Statements ◽  
Plasma Filtration ◽  
High Volume Hemofiltration ◽  
Refractory Septic Shock

Background Extracorporeal blood purification treatment (EBT) methods have been used in the treatment of experimental and human SIRS/Sepsis in a variety of settings and with variable reports of efficacy and safety. Their role in the management of SIRS/Sepsis remains controversial. Objectives To develop consensus statements regarding important aspects of research, practice and technical management concerning EBT. Methods Systematic review of published study. Evidence-based grading of information available. Consensus development regarding fundamental questions about EBT. Results Consensus was achieved on all questions posed during the conference. It was agreed that there is currently a clear biological rational for EBT in SIRS and Sepsis. It was agreed that conventional CVVH has sufficiently been shown not to be effective in SIRS/Sepsis in the absence of concomitant ARF and that other therapies such as plasmapheresis or high-volume hemofiltration or coupled plasma filtration adsorption appear more promising and should be tested in multicentre randomized controlled trials. Patients with ARF and SIRS/Sepsis should be treated differently from those with ARF alone even though current practice in this field is not well known. Patients with refractory septic shock should be considered for EBT. Appropriate end points for clinical trials can be defined and chosen according to the goals of the trial. Different technologies exist for EBT and better understanding of the merits and safety of each is needed as well as better standardization of methodology and dose. Conclusions Broad consensus can be achieved on several aspects of EBT and can be used to inform clinical practice and to help guide the establishment of a future research agenda.

High-Volume Hemofiltration as Rescue Therapy for Refractory Shock After Inadvertent Rapid Aprotinin Administration

2009 ◽  
Vol 23 (4) ◽  
pp. 526-528 ◽  
Author(s):  
Romuald Lango ◽  
Maciej Michał Kowalik ◽  
Katarzyna Klajbor ◽  
Rafał Pawlaczyk ◽  
Violetta Musiał-Świątkiewicz ◽  
...  
Keyword(s):  
Rescue Therapy ◽  
High Volume ◽  
Refractory Shock ◽  
High Volume Hemofiltration

scholarly journals Early Cytokine Removal in Critical COVID-19 Patients with Extracorporeal Therapies (HA-380 plus High Volume Hemofiltration) May Prevent Progression of Acute Respiratory Distress Syndrome: Case Report

2020 ◽  
pp. 1-3
Author(s):  
Gonzalo Ramírez-Guerrero ◽  
Vicente Torres Cifuentes ◽  
Romyna Baghetti Hernández ◽  
Francisco Villagrán Cortés ◽  
Simón Rojas Doll ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Clinical Case ◽  
Distress Syndrome ◽  
High Volume ◽  
Cytokine Release ◽  
Cytokine Release Syndrome ◽  
Hemodynamic Deterioration ◽  
High Volume Hemofiltration

We present the case of a patient who suffered from acute respiratory distress syndrome caused by pneumonia associated with COVID-19 and cytokine release syndrome. This patient received a high-volume hemofiltration plus adsorption, solving the hemodynamic deterioration, pulmonary infiltrates, and gas exchange. Our clinical case proposes that the extracorporeal therapies can have a role in the management of severe COVID-19.

scholarly journals High-Volume Hemofiltration After Out-of-Hospital Cardiac Arrest

2005 ◽  
Vol 46 (3) ◽  
pp. 432-437 ◽  
Author(s):  
Ivan Laurent ◽  
Christophe Adrie ◽  
Christophe Vinsonneau ◽  
Alain Cariou ◽  
Jean-Daniel Chiche ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
High Volume ◽  
High Volume Hemofiltration ◽  
Hospital Cardiac Arrest
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