Eficacia del CytoSorb en un paciente en ECMO V-V secundario a síndrome respiratorio agudo severo por coronavirus 2 (SARS-CoV-2). Reporte de caso y revisión de la literatura

Adult respiratory distress syndrome (ARDS) due to the SARS-CoV-2 virus has high morbidity and mortality secondary to severe pulmonary involvement added to a dysregulated immune response that causes a cytokine storm and organ dysfunction. Veno-venous extracorporeal membrane oxygenation (VV ECMO) is a rescue support that has been demonstrating effectiveness in severe and refractory cases of ARDS; however, it can also generate a systemic inflammatory response due to the contact of blood with a foreign surface. For these reasons, blood purification strategies such as haeme adsorption with CytoSorb are a therapeutic alternative to an exaggerated release of cytokines. We describe the case of a young patient with severe and refractory ARDS due to SARS CoV-2 with the need for ECMO support, and subsequent symptoms of cytokine storm due to hypotension and multi-organ dysfunction, who required extracorporeal removal of cytokines with CytoSorb, with which he achieved clinical stabilization that allowed withdrawal of extracorporeal support.