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Critical Care
Published in: Critical Care 1/2020

Open Access 01-12-2020 | Pneumonia | Research Letter

Therapeutic plasma exchange in patients with COVID-19 pneumonia in intensive care unit: a retrospective study

Authors: Bulent Gucyetmez, Hakan Korkut Atalan, Ibrahim Sertdemir, Ulkem Cakir, Lutfi Telci, COVID-19 Study Group

Published in: Critical Care | Issue 1/2020

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Excerpt

In patients with COVID-19 pneumonia, high risk of thrombosis became a current issue, and d-dimer levels indicating fibrin degradation products (FDPs) in the plasma were found as a predictor for mortality [1, 2]. Although unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) decrease the production of FDPs by inhibiting factors Xa and II, they cannot contribute metabolization of existing FDPs. Furthermore, FDPs cannot be filtered by known cytokine filters because of their molecular weight (minimum 240 kDa) [3, 4]. Yet, FDPs can be removed by therapeutic plasma exchange (TPE) [5]. Therefore, recently, three consecutive TPE sessions were performed in selected patients with COVID-19 pneumonia in intensive care units (ICUs) after the assessment of their clinical and coagulation status. In the study, the effect of TPE on outcomes was retrospectively investigated in patients with COVID-19 pneumonia. …
Literature
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Helms J, Tacquard C, Severac F, Leonard-Lorant I, Ohana M, Delabranche X, et al. High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study. Intensive Care Med. 2020;46:1089–98.
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Zhang L, Yan X, Fan Q, Liu H, Liu X, Liu Z, et al. D-dimer levels on admission to predict in-hospital mortality in patients with Covid-19. J Thromb Haemost. 2020;18:1324–9.
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Diab M, Platzer S, Guenther A, Sponholz C, Scherag A, Lehmann T, Velichkov I, Hagel S, Bauer M, Brunkhorst FM, et al. Assessing efficacy of CytoSorb haemoadsorber for prevention of organ dysfunction in cardiac surgery patients with infective endocarditis: REMOVE-protocol for randomised controlled trial. BMJ Open. 2020;10(3):e031912.CrossRef
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Walker JB, Nesheim ME. The molecular weights, mass distribution, chain composition, and structure of soluble fibrin degradation products released from a fibrin clot perfused with plasmin. J Biol Chem. 1999;274(8):5201–12.CrossRef
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Rimmer E, Houston BL, Kumar A, Abou-Setta AM, Friesen C, Marshall JC, Rock G, Turgeon AF, Cook DJ, Houston DS, et al. The efficacy and safety of plasma exchange in patients with sepsis and septic shock: a systematic review and meta-analysis. Crit Care. 2014;18(6):699.CrossRef
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Honore PM, Mugisha A, Kugener L, Redant S, Attou R, Gallerani A, De Bels D. Therapeutic plasma exchange as a routine therapy in septic shock and as an experimental treatment for COVID-19: we are not sure. Crit Care. 2020;24(1):226.CrossRef
Metadata
Title
Therapeutic plasma exchange in patients with COVID-19 pneumonia in intensive care unit: a retrospective study
Authors
Bulent Gucyetmez
Hakan Korkut Atalan
Ibrahim Sertdemir
Ulkem Cakir
Lutfi Telci
COVID-19 Study Group
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2020
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-020-03215-8

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