Efficacy of hemoperfusion in COVID-19 patients with difficult weaning from mechanical ventilation

Abstract

Background: Weaning of ventilated COVID-19 patients from ventilators has been a major problem in some of these patients. We performed hemoperfusion in a selective group of COVID-19 patients to facilitate weaning from the mechanical ventilation (MV).

Methodology: The present study was a retrospective case series of 30 consecutive COVID-19 patients, who showed difficulty with weaning off the ventilator. Hemoperfusion was performed by the HA330 disposable hemoperfusion cartridge (Jafron, China). Before and after hemoperfusion, changes in patients' hemodynamics, improvement in consciousness level, oxygen saturation, hypercapnia, initiating spontaneous breathing, and changes in lung involvement were assessed.

Results: The patients average age was 48.38 ± 15.04 years, with 17 (56.7%) females. The post-hemoperfusion values of SpO₂ (P < 0.001), mean arterial pressure (P = 0.003), positive end-expiratory pressure (P < 0.001), heart rate (P < 0.001), and ratio of arterial oxygen partial pressure to fractional inspired oxygen (P < 0.001) were significantly different compared to their pre-hemoperfusion values. The outcome of patients showed a significant relationship with age (P = 0.017) and spontaneous ventilation (P = 0.001).

Conclusions: The findings endorse the implementation of hemoperfusion for ICU-hospitalized COVID-19 patients experiencing difficulty in weaning from mechanical ventilation. Hemoperfusion demonstrated significant improvements in vital signs for the majority of patients and was associated with a successful weaning and survival rate of 63.3%. While these results are promising, further evidence is needed to consider hemoperfusion as an accepted clinical approach.