First successful combination of ECMO with cytokine removal therapy in XXXX : a case report.

@entity1 @entity650 @entity295 @entity649 @entity1904 @entity740 @entity810 @entity1167 @entity1455 @entity221 @entity1851
PURPOSE: A new hemoadsorption device intended as adjunctive treatment for @entity1 with elevated cytokine levels in the setting of SIRS and @entity295 has shown promising results. We report on the beneficial application of the device in a @entity1 with @entity1455 receiving combined extracorporeal life support with rECMO, LVAD, and CVVH despite his highly septic condition. METHODS: A 39-year-old @entity1 presented with fulminant @entity649 and @entity1455 . A veno-arterial ECMO was implanted for circulatory support. During the course of @entity221 , the @entity1 developed @entity810 in addition to his @entity740 , making initiation of CVVH necessary. Due to a complete @entity1167 in both ventricles, a left ventricular assist device (LVAD) in combination with right ECMO (rECMO) was implanted despite manifest septic conditions. In the post-operative course @entity650 levels and vasopressor dosages increased drastically. A CytoSorb hemoadsorption device was therefore installed in the CVVH circuit and 3 sessions were run during the following 4 days. RESULTS: During CytoSorb treatment, inflammatory markers @entity650 , @entity1904 , and @entity1851 decreased concomitant with significantly reduced vasopressor support. No adverse device-related side effects were documented during or after the treatment sessions. CONCLUSIONS: This is the first clinical case report of a highly septic @entity1 treated with the combined use of LVAD, rECMO, CVVH, and CytoSorb. The combination was practical, technically feasible, and beneficial for the @entity1 . This combination represents a reasonable approach to improve survival in @entity1 with multiple organ dysfunction necessitating several organ supportive techniques.
