Post VV-ECMO Weaning Hyperinflammation-Can Prophylactic Hemoadsorption Treatment Prevent Complications?

Medicina (Kaunas). 2023 Oct 12;59(10):1818. doi: 10.3390/medicina59101818.

Abstract

Acute respiratory distress syndrome (ARDS) is a severe clinical condition characterized by acute respiratory failure and a high mortality risk despite conventional mechanical ventilatory support. Veno-venous extracorporeal membrane oxygenation (vvECMO) has emerged as an effective life-support technology for patients with ARDS. However, complications may arise following the decannulation of vvECMO, with a relatively frequent development of systemic hyperinflammation (SHI). Among the various treatment strategies for SHI, the use of hemoadsorption with CytoSorb® has shown promising results in removing excessive levels of cytokines and attenuating the hyperinflammatory response. In this case series, we present three critically ill patients with ARDS secondary to pneumonia who underwent vvECMO and subsequently received prophylactic hemoadsorption with CytoSorb® following decannulation as a part of our clinical practice. This case series aims to describe the potential positive effects of hemoadsorption in preventing the development of SHI after vvECMO decannulation in ARDS patients.

Keywords: CytoSorb; ECMO; hemoadsorption; hyperinflammation.

Publication types

  • Case Reports

MeSH terms

  • Critical Illness
  • Cytokines
  • Extracorporeal Membrane Oxygenation* / methods
  • Humans
  • Respiratory Distress Syndrome* / etiology
  • Respiratory Distress Syndrome* / prevention & control
  • Ventilator Weaning

Substances

  • Cytokines

Grants and funding

This research received no external funding.