Hemoperfusion as an Adjuvant Therapy in Maintenance Hemodialysis Patients with Severe COVID-19: A Single Centre Experience

Authors

  • Elizabeth Yasmine Wardoyo Division of Renal Hypertension, Department of Internal Medicine, Fatmawati Hospital, Jakarta, Indonesia
  • Anggraini Permata Sari Division of Renal Hypertension, Department of Internal Medicine, Fatmawati Hospital, Jakarta, Indonesia
  • Aryan Y Djojo Division of Renal Hypertension, Department of Internal Medicine, Fatmawati Hospital, Jakarta, Indonesia
  • Johanes Sarwono Division of Renal Hypertension, Department of Internal Medicine, Fatmawati Hospital, Jakarta, Indonesia
  • Md Ikhsan Mokoagow Department of Internal Medicine, Fatmawati Hospital, Jakarta, Indonesia
  • Nikko Darnindro Department of Internal Medicine, Fatmawati Hospital, Jakarta, Indonesia
  • Jerry Nasarudin Department of Internal Medicine, Fatmawati Hospital, Jakarta, Indonesia
  • Marina Epriliawati Department of Internal Medicine, Fatmawati Hospital, Jakarta, Indonesia
  • Annela Manurung Department of Internal Medicine, Fatmawati Hospital, Jakarta, Indonesia
  • Martha Iskandar Department of Internal Medicine, Fatmawati Hospital, Jakarta, Indonesia
  • Krishna Adi Wibisana Department of Internal Medicine, Fatmawati Hospital, Jakarta, Indonesia
  • Anak Agung Arie Widyastuti Department of Internal Medicine, Fatmawati Hospital, Jakarta, Indonesia
  • Radhiyatam Mardiyah Department of Internal Medicine, Fatmawati Hospital, Jakarta, Indonesia

Keywords:

hemoperfusion, hemodialysis, COVID-19, cytokines, resin

Abstract

Mortality rate among maintenance hemodialysis (HD) patients with COVID-19 is alarmingly high. In Fatmawati General Hospital, most of HD patients with COVID-19 presented with acute respiratory distress syndrome (ARDS). Hemoperfusion (HP) is a blood purification therapy used to remove cytokines and inflammatory mediators to prevent ARDS worsening and organ failure. We report 6 cases of COVID-19 in maintenance HD patients. HP and HD were performed in two consecutive days when patient developed early ARDS as indicated by inflammatory markers elevation. HP and HD were conducted by using resin-containing cartridge and high-flux dialyzer, respectively, for 4 hours. Improvements in CRP levels, PaO2/FiO2 ratios, and chest X-rays were observed after 2 sessions of HP in most of our patients. Based on our clinical experience, the timing of HP delivery is critical and should be undertaken in the early phase of ARDS, but larger studies are still needed.

Author Biography

Elizabeth Yasmine Wardoyo, Division of Renal Hypertension, Department of Internal Medicine, Fatmawati Hospital, Jakarta, Indonesia

KSM Penyakit Dalam RSUP Fatmawati

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Published

2022-09-24

How to Cite

Wardoyo, E. Y., Sari, A. P., Djojo, A. Y., Sarwono, J., Mokoagow, M. I., Darnindro, N., Nasarudin, J., Epriliawati, M., Manurung, A., Iskandar, M., Wibisana, K. A., Widyastuti, A. A. A., & Mardiyah, R. (2022). Hemoperfusion as an Adjuvant Therapy in Maintenance Hemodialysis Patients with Severe COVID-19: A Single Centre Experience. Acta Medica Indonesiana, 54(3), 444. Retrieved from https://actamedindones.org/index.php/ijim/article/view/2039