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Evaluation of Plasma Exchange and Continuous Veno-Venous Hemofiltration for the Treatment of Severe Avian Influenza A (H7N9): A Cohort Study

tetano

Editor, Senior Moderator
Ther Apher Dial. 2014 Nov 3. doi: 10.1111/1744-9987.12240. [Epub ahead of print]
Evaluation of Plasma Exchange and Continuous Veno-Venous Hemofiltration for the Treatment of Severe Avian Influenza A (H7N9): A Cohort Study.
Liu X1, Zhang Y, Xu X, Du W, Su K, Zhu C, Chen Y, Lei S, Zheng S, Jiang J, Yang S, Guo J, Shao L, Yang Q, Chen J, Li L.
Author information
Abstract

Avian influenza A (H7N9) is a severe disease with high mortality. Hypercytokinemia is thought to play an important role in the pathogenesis. This study was to investigate the efficiency of plasma exchange (PE) + continuous veno-venous hemofiltration (CVVH) on the removal of inflammatory mediators and their benefits in the management of fluid overload and metabolic disturbance. In total, 40 H7N9-infected patients were admitted to our hospital. Sixteen critically ill H7N9-infected patients received combination of PE and CVVH. Data from these 16 patients were collected and analyzed. The effects of PE + CVVH on plasma cytokine/chemokine levels and clinical outcomes were examined. H7N9-infected patients had increased plasma levels compared to healthy controls. After 3 h of PE + CVVH treatment, the cytokine/chemokine levels descended remarkably to lower levels and were maintained thereafter. PE + CVVH also benefited the management of fluid, cardiovascular dysfunction and metabolic disturbance. Of the 16 critically ill patients who received PE + CVVH, 10 patients survived. PE + CVVH decreased the plasma cytokine/chemokine levels significantly. PE + CVVH were also beneficial to the management of severe avian influenza A (H7N9).

? 2014 The Authors. Therapeutic Apheresis and Dialysis ? 2014 International Society for Apheresis.
KEYWORDS:

Avian influenza A; Cytokine; H7N9; Hemofiltration; Plasma exchange

PMID:
25363618
[PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25363618
 
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