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Cytokine Storm Syndrome Triggered by Extracorporeal Membrane Oxygenation in Pediatric Patients

Daniel D Reiff1, Randy Q Cron1

  • 1Department of Pediatrics, Division of Rheumatology, University of Alabama at Birmingham, Birmingham, AL 35233, USA.

Children (Basel, Switzerland)
|June 28, 2023
PubMed

Insights

Cytokine storm syndrome (CSS) related to ECMO can be life-threatening. Anakinra, an IL-1 receptor antagonist, effectively treated two patients with ECMO-related CSS, improving inflammation and cardiorespiratory status.

Area of Science:

  • Critical Care Medicine
  • Immunology
  • Cardiovascular Surgery

Background:

  • Cytokine storm syndrome (CSS) involves severe systemic inflammation and cytokine release.
  • Hyper-inflammation patterns similar to CSS occur in patients undergoing cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO).
  • Current treatments for CPB/ECMO-induced hyper-inflammation are often ineffective.

Purpose of the Study:

  • To investigate the efficacy of anakinra, an interleukin-1 receptor antagonist, in treating ECMO-related CSS.
  • To evaluate anakinra's impact on severe hyper-inflammation and life-threatening sequelae in ECMO patients.

Main Methods:

  • Case study of two patients with ECMO-related CSS experiencing vasodilatory shock and respiratory failure.
  • Administration of anakinra as a targeted cytokine-directed therapy.

Main Results:

  • Both patients showed significant improvement in hyper-inflammation markers.
  • Cardiorespiratory status improved substantially following anakinra treatment.
  • Anakinra demonstrated good effect in managing ECMO-related CSS.

Conclusions:

  • Anakinra shows promise as a specific cytokine-directed therapy for ECMO-related CSS.
  • Targeted cytokine therapies have potential to improve treatment and outcomes for CPB/ECMO-related CSS.
  • Further research into cytokine-directed therapies for CSS in critical care settings is warranted.

Keywords:
cardiopulmonary bypasscytokinecytokine stormextracorporeal membrane oxygenationinflammation

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