RESUMO
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.
Assuntos
Hemofiltração , Hemorragia Subaracnóidea/terapia , Hemofiltração/instrumentação , Humanos , Interleucina-6/sangue , Aneurisma Intracraniano/sangue , Aneurisma Intracraniano/complicações , Aneurisma Intracraniano/terapia , Masculino , Pessoa de Meia-Idade , Hemorragia Subaracnóidea/sangue , Hemorragia Subaracnóidea/complicaçõesRESUMO
Sepsis is one of the leading causes of death in critically ill patients with COVID-19 and blood purification therapies have a role to immunomodulate the excessive inflammatory response and improve clinical results. One of the devices designed for these therapies is the oXiris® filter, allowing to perform renal replacement therapy combined with selective adsorption of endotoxins and cytokines. We report a 55-year-old male with COVID who developed a septic shock secondary to a sepsis caused by Pseudomona aeruginosa, refractory to the usual management. A veno-venous continuous hemofiltration was started using the oXiris® filter for 48 hours. Subsequently, there was an improvement in clinical perfusion parameters and a reduction in inflammatory markers. The patient was discharged from the intensive care one month later.
Assuntos
COVID-19 , Sepse , Choque Séptico , COVID-19/complicações , Citocinas , Endotoxinas , Humanos , Masculino , Pessoa de Meia-Idade , Sepse/complicações , Choque Séptico/complicações , Choque Séptico/terapiaRESUMO
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.
Assuntos
COVID-19/terapia , Estado Terminal/terapia , Síndrome da Liberação de Citocina/prevenção & controle , Hemofiltração , Hemoperfusão , SARS-CoV-2 , Injúria Renal Aguda/etiologia , Corticosteroides/uso terapêutico , Antivirais/uso terapêutico , COVID-19/complicações , COVID-19/diagnóstico por imagem , Terapia Combinada , Síndrome da Liberação de Citocina/etiologia , Citocinas/sangue , Progressão da Doença , Quimioterapia Combinada , Hemoperfusão/métodos , Humanos , Hiperpotassemia/etiologia , Masculino , Pessoa de Meia-Idade , Respiração Artificial , Síndrome do Desconforto Respiratório/diagnóstico por imagem , Síndrome do Desconforto Respiratório/etiologia , Síndrome do Desconforto Respiratório/terapia , Vasoconstritores/uso terapêutico , Tratamento Farmacológico da COVID-19RESUMO
Sepsis is one of the leading causes of death in critically ill patients with COVID-19 and blood purification therapies have a role to immunomodulate the excessive inflammatory response and improve clinical results. One of the devices designed for these therapies is the oXiris® filter, allowing to perform renal replacement therapy combined with selective adsorption of endotoxins and cytokines. We report a 55-year-old male with COVID who developed a septic shock secondary to a sepsis caused by Pseudomona aeruginosa, refractory to the usual management. A veno-venous continuous hemofiltration was started using the oXiris® filter for 48 hours. Subsequently, there was an improvement in clinical perfusion parameters and a reduction in inflammatory markers. The patient was discharged from the intensive care one month later.