EC Emergency Medicine And Critical Care

Background: COVID-19 dissemination began at the end of 2019 and resulted in an ever-increasing number of cases and deaths worldwide. Due to the lack of effective antiviral drugs, severely and critically ill patients need full active supportive treatment, including extracorporeal organ support therapies for multiple organ support. However, evidence of specific treatments, such as blood purification, for cardiorenal organ failure with COVID-19 is still lacking.

Summary: We performed this review to report the current understanding and principles for blood purification management of patients with COVI‐19 based on recent experience, latest publications, and expert reports, to encourage safe, accurate, and effective performance. Recommendations on modality selection, indication and timing, infection prevention and control management, selection of equipment and filter, and technical and clinical monitoring are discussed. The fundamental practice of blood purification management in these settings is described for vascular access, mode and dosage, anticoagulation strategy, fluid management, drug adjustment, and weaning time of blood purification.

Key Messages: We provide recommendations on the clinical practice of blood purification in all aspects, including modality, indication and timing, infection prevention and control management, and selection of equipment and filters based on the latest publications.

 Keywords: SARS-CoV-2; COVID-19; Blood Purification; CRRT; Extracorporeal Therapies; Extracorporeal Organ Support; AKI; Cytokine Storm; Recommendation

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