4.5 Article

Cytokine Storm Syndrome Triggered by Extracorporeal Membrane Oxygenation in Pediatric Patients

Journal

CHILDREN-BASEL
Volume 10, Issue 6, Pages -

Publisher

MDPI
DOI: 10.3390/children10061052

Keywords

cytokine storm; inflammation; cardiopulmonary bypass; extracorporeal membrane oxygenation; cytokine

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Cytokine storm syndrome (CSS) is a serious condition caused by severe systemic inflammation and immune activation. The use of cytokine-directed therapies, such as interleukin-1 receptor antagonist, has shown promising results in treating CSS in ECMO patients.
Cytokine storm syndrome (CSS) is a serious and potentially life-threatening condition caused by severe systemic inflammation, immune activation, and a positive feedback loop of cytokine release. Typically triggered by systemic infection, malignancy, monogenic or rheumatic disease, similar patterns of hyper-inflammation have been seen in patients undergoing cardiopulmonary bypass (CPB) and in patients treated with extracorporeal membrane oxygenation (ECMO). Typical treatments used for the prevention and treatment of CPB/ECMO-induced hyper-inflammation have not been shown to be substantially effective. Two patients suffering from ECMO-related CSS were identified by their severe hyper-inflammatory profile and life-threatening sequelae of vasodilatory shock and respiratory failure. Anakinra, an interleukin-1 receptor antagonist, was employed as specific cytokine-directed therapy for the treatment of CSS in these two patients to good effect, with significant improvement in hyper-inflammation and cardiorespiratory status. The use of cytokine-directed therapies in CPB/ECMO-related CSS has great potential to improve the treatment and outcomes of this serious condition.

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