Abstract
Critically ill COVID-19 patients are generally admitted to the ICU for respiratory insufficiency which can evolve into a multiple-organ dysfunction syndrome requiring extracorporeal organ support. Ongoing advances in technology and science and progress in information technology support the development of integrated multi-organ support platforms for personalized treatment according to the changing needs of the patient. Based on pathophysiological derangements observed in COVID-19 patients, a rationale emerges for sequential extracorporeal therapies designed to remove inflammatory mediators and support different organ systems. In the absence of vaccines or direct therapy for COVID-19, extracorporeal therapies could represent an option to prevent organ failure and improve survival. The enormous demand in care for COVID-19 patients requires an immediate response from the scientific community. Thus, a detailed review of the available technology is provided by experts followed by a series of recommendation based on current experience and opinions, while waiting for generation of robust evidence from trials.
References
1.
Ronco
C
, Reis
T
. Kidney involvement in Covid-19 patients and the role of extracorporeal therapies, NRNeph
. Nat Rev Nephrol
. 2020 Apr 9
. .2.
Kramer
P
, Wigger
W
, Rieger
J
, Matthaei
D
, Scheler
F
. [Arteriovenous haemofiltration: a new and simple method for treatment of over-hydrated patients resistant to diuretics]
. Klin Wochenschr
. 1977
;55
(22
):1121
–2
. 3.
Ronco
C
. Continuous renal replacement therapy: forty-year anniversary
. Int J Artif Organs
. 2017 May 31
;40
(6
):257
–64
. 4.
Ronco
C
, Garzotto
F
, Brendolan
A
, Zanella
M
, Bellettato
M
, Vedovato
S
, et al. Continuous renal replacement therapy in neonates and small infants: development and first-in-human use of a miniaturised machine (CARPEDIEM)
. Lancet
. 2014
;383
(9931
):1807
–13
. 5.
Villa
G
, Neri
M
, Bellomo
R
, Cerda
J
, De Gaudio
AR
, De Rosa
S
, et al. Nomenclature for renal replacement therapy and blood purification techniques in critically ill patients: practical applications
. Crit Care
. 2016
;20
(1
):283
. 6.
Schneider
A
, Ostermann
M
. The AKI glossary
. Intensive Care Med
. 2017
;43
(6
):893
–7
. 7.
Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group
. KDIGO clinical practice guideline for acute kidney injury
. Kidney Int
. 2012
;2012
:1
–138
.8.
Ronco
C
, Ricci
Z
, De Backer
D
, Kellum
JA
, Taccone
FS
, Joannidis
M
, et al. Renal replacement therapy in acute kidney injury: controversy and consensus
. Crit Care
. 2015
;19
:146
. 9.
Husain-Syed
F
, Ricci
Z
, Brodie
D
, Vincent
JL
, Ranieri
VM
, Slutsky
AS
, et al. Extracorporeal organ support (ECOS) in critical illness and acute kidney injury: from native to artificial organ crosstalk
. Intensive Care Med
. 2018
;44
(9
):1447
–59
. 10.
Ostermann
M
. Techniques and modalities of continuous renal replacement therapy
. Contrib Nephrol
. 2018
;194
:51
–9
. 11.
Ronco
C
, Bellomo
R
, Homel
P
, Brendolan
A
, Dan
M
, Piccinni
P
, et al. Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure: a prospective randomised trial
. Lancet
. 2000
;356
(9223
):26
–30
. 12.
Bagshaw
SM
, Darmon
M
, Ostermann
M
, Finkelstein
FO
, Wald
R
, Tolwani
AJ
, et al. Current state of the art for renal replacement therapy in critically ill patients with acute kidney injury
. Intensive Care Med
. 2017
;43
(6
):841
–54
. 13.
Ankawi
G
, Neri
M
, Zhang
J
, Breglia
A
, Ricci
Z
, Ronco
C
. Extracorporeal techniques for the treatment of critically ill patients with sepsis beyond conventional blood purification therapy: the promises and the pitfalls
. Crit Care
. 2018
;22
(1
):262
. 14.
Schwenger
V
, Weigand
MA
, Hoffmann
O
, Dikow
R
, Kihm
LP
, Seckinger
J
, et al. Sustained low efficiency dialysis using a single-pass batch system in acute kidney injury: a randomized interventional trial: the REnal Replacement Therapy Study in Intensive Care Unit PatiEnts
. Crit Care
. 2012
;16
(4
):R140
. 15.
Zhang
L
, Yang
J
, Eastwood
GM
, Zhu
G
, Tanaka
A
, Bellomo
R
. Extended daily dialysis versus continuous renal replacement therapy for acute kidney injury: a meta-analysis
. Am J Kidney Dis
. 2015
;66
(2
):322
–30
. 16.
Ostermann
M
, Joannidis
M
, Pani
A
, Floris
M
, De Rosa
S
, Kellum
JA
, et al. Patient selection and timing of continuous renal replacement therapy
. Blood Purif
. 2016
;42
(3
):224
–37
. 17.
Davenport
A
, Will
EJ
, Davison
AM
. Effect of renal replacement therapy on patients with combined acute renal and fulminant hepatic failure
. Kidney Int Suppl
. 1993
;41
:S245
–51
.18.
Ostermann
M
, Connor
M
Jr, Kashani
K
. Continuous renal replacement therapy during extracorporeal membrane oxygenation: why, when and how?
Curr Opin Crit Care
. 2018
;24
(6
):493
–503
. 19.
Bonnassieux
M
, Duclos
A
, Schneider
AG
, Schmidt
A
, Bénard
S
, Cancalon
C
, et al. Renal replacement therapy modality in the ICU and renal recovery at hospital discharge
. Crit Care Med
. 2018
;46
:e102
–10
. 20.
Schneider
AG
, Bellomo
R
, Bagshaw
SM
, Glassford
NJ
, Lo
S
, Jun
M
, et al. Choice of renal replacement therapy modality and dialysis dependence after acute kidney injury: a systematic review and meta-analysis
. Intensive Care Med
. 2013
;39
(6
):987
–97
. 21.
Wald
R
, Shariff
SZ
, Adhikari
NK
, Bagshaw
SM
, Burns
KE
, Friedrich
JO
, et al. The association between renal replacement therapy modality and long-term outcomes among critically ill adults with acute kidney injury: a retrospective cohort study
. Crit Care Med
. 2014
;42
(4
):868
–77
. 22.
Chawla
LS
, Bellomo
R
, Bellomo
R
, Bihorac
A
, Goldstein
SL
, Siew
ED
, et al. Acute kidney disease and renal recovery: consensus report of the acute disease quality initiative (ADQI) 16 workgroup
. Nat Rev Nephrol
. 2017
;13
(4
):241
–57
. 23.
Liang
KV
, Sileanu
FE
, Clermont
G
, Murugan
R
, Pike
F
, Palevsky
PM
, et al. Modality of RRT and recovery of kidney function after AKI in patients surviving to hospital discharge
. Clin J Am Soc Nephrol
. 2016
;11
(1
):30
–8
. 24.
Cerdá
J
, Baldwin
I
, Honore
PM
, Villa
G
, Kellum
JA
, Ronco
C
, et al. Role of technology for the management of AKI in critically Ill patients: from adoptive technology to precision continuous renal replacement therapy
. Blood Purif
. 2016
;42
(3
):248
–65
. 25.
Bellmann
R
, Graziadei
IW
, Feistritzer
C
, Schwaighofer
H
, Stellaard
F
, Sturm
E
, et al. Treatment of refractory cholestatic pruritus after liver transplantation with albumin dialysis
. Liver Transpl
. 2004
;10
(1
):107
–14
. 26.
Saliba
F
, Camus
C
, Durand
F
, Mathurin
P
, Letierce
A
, Delafosse
B
, et al. Albumin dialysis with a noncell artificial liver support device in patients with acute liver failure: a randomized, controlled trial
. Ann Intern Med
. 2013
;159
(8
):522
–31
. 27.
Bañares
R
, Nevens
F
, Larsen
FS
, Jalan
R
, Albillos
A
, Dollinger
M
, et al. Extracorporeal albumin dialysis with the molecular adsorbent recirculating system in acute-on-chronic liver failure: the RELIEF trial
. Hepatology
. 2013
;57
(3
):1153
–62
. 28.
Sponholz
C
, Matthes
K
, Rupp
D
, Backaus
W
, Klammt
S
, Karailieva
D
, et al. Molecular adsorbent recirculating system and single-pass albumin dialysis in liver failure: a prospective, randomised crossover study
. Crit Care
. 2016
;20
:2
. 29.
Larsen
FS
, Schmidt
LE
, Bernsmeier
C
, Rasmussen
A
, Isoniemi
H
, Patel
VC
, et al. High-volume plasma exchange in patients with acute liver failure: an open randomised controlled trial
. J Hepatol
. 2016
;64
(1
):69
–78
. 30.
Yao
J
, Li
S
, Zhou
L
, Luo
L
, Yuan
L
, Duan
Z
, et al. Therapeutic effect of double plasma molecular adsorption system and sequential half-dose plasma exchange in patients with HBV-related acute-on-chronic liver failure
. J Clin Apher
. 2019 Aug
;34
(4
):392
–8
. 31.
Huang
Z
, Wang
SR
, Su
W
, Liu
JY
. Removal of humoral mediators and the effect on the survival of septic patients by hemoperfusion with neutral microporous resin column
. Ther Apher Dial
. 2010 Dec
;14
(6
):596
–602
. 32.
Hassan
K
, Kannmacher
J
, Wohlmuth
P
, Budde
U
, Schmoeckel
M
, Geidel
S
. Cytosorb adsorption during emergency cardiac operations in patients at high risk of bleeding
. Ann Thorac Surg
. 2019
;108
(1
):45
–51
. 33.
Imai
Y
, Parodo
J
, Kajikawa
O
, de Perrot
M
, Fischer
S
, Edwards
V
, et al. Injurious mechanical ventilation and end-organ epithelial cell apoptosis and organ dysfunction in an experimental model of acute respiratory distress syndrome
. JAMA
. 2003
;289
(16
):2104
–12
. 34.
Duscio
E
, Cipulli
F
, Vasques
F
, Collino
F
, Rapetti
F
, Romitti
F
, et al. Xtracorporeal CO2 removal: the minimally invasive approach, theory, and practice
. Crit Care Med
. 2019
;47
(1
):33
–40
. 35.
Combes
A
, Fanelli
V
, Pham
T
, Ranieri
VM
. Feasibility and safety of extracorporeal CO2 removal to enhance protective ventilation in acute respiratory distress syndrome: the SUPERNOVA study
. Intensive Care Med Feb
. 2019
;45
(5
);592
–600
. 36.
Morelli
A
, Del Sorbo
L
, Pesenti
A
, Ranieri
VM
, Fan
E
. Extracorporeal carbon dioxide removal (ECCO2R) in patients with acute respiratory failure
. Intensive Care Med
.2017
;43
(4
):519
–30
. 37.
Fanelli
V
, Ranieri
MV
, Mancebo
J
, Moerer
O
, Quintel
M
, Morley
S
, et al. Feasibility and safety of low-flow extracorporeal carbon dioxide removal to facilitate ultra-protective ventilation in patients with moderate acute respiratory distress sindrome
. Crit Care
. 2016
;20
:36
. 38.
Nolte
SH
, Jonitz
WJ
, Grau
J
, Roth
H
, Assenbaum
ER
. Hemodialysis for extracorporeal bicarbonate/CO2 removal (ECBicCO2R) and apneic oxygenation for respiratory failure in the newborn. Theory and preliminary results in animal experiments
. ASAIO Trans
. 1989
;35
(1
):30
–4
.39.
Forster
C
, Schriewer
J
, John
S
, Eckardt
KU
, Willam
C
. Low-flow CO2 removal integrated into a renal-replacement circuit can reduce acidosis and decrease vasopressor requirements
. Crit Care
. 2013
;17
(4
):R154
. 40.
Quintard
JM
, Barbot
O
, Thevenot
F
, de Matteis
O
, Benayoun
L
, Leibinger
F
. Partial extracorporeal carbon dioxide removal using a standard continuous renal replacement therapy device: a preliminary study
. ASAIO J
. 2014
;60
(5
):564
–9
. 41.
Allardet-Servent
J
, Castanier
M
, Signouret
T
, Soundaravelou
R
, Lepidi
A
, Seghboyan
JM
. Safety and efficacy of combined extracorporeal CO2 removal and renal replacement therapy in patients with acute respiratory distress syndrome and acute kidney injury: the pulmonary and renal support in acute respiratory distress syndrome study
. Crit Care Med
. 2015
;43
(12
):2570
–81
. 42.
Fanelli
V
, Cantaluppi
V
, Alessandri
F
, Costamagna
A
, Cappello
P
, Brazzi
L
, et al. Extracorporeal CO2 removal May improve renal function of patients with acute respiratory distress syndrome and acute kidney injury: an open-label, interventional clinical trial
. Am J Respir Crit Care Med
. 2018
;198
(5
):687
–90
. 43.
Schmidt
M
, Jaber
S
, Zogheib
E
, Godet
T
, Capellier
G
, Combes
A
. Feasibility and safety of low-flow extracorporeal CO2 removal managed with a renal replacement platform to enhance lung-protective ventilation of patients with mild-to-moderate ARDS
. Crit Care
. 2018
;22
(1
):122
. 44.
Chang
BS
, Garella
S
. Complete extracorporeal removal of metabolic carbon dioxide by alkali administration and dialysis in apnea
. Int J Artif Organs
. 1983
;6
(6
):295
–8
. 45.
Isobe
J
, Mizuno
H
, Matsunobe
S
, Shimizu
Y
, Ikada
Y
, Kishida
A
. A new type of low blood flow ECCO2R using a hemodialysis system in apneic states
. ASAIO Trans
. 1989
;35
(3
):638
–9
. 46.
Cressoni
M
, Zanella
A
, Epp
M
, Corti
I
, Patroniti
N
, Kolobow
T
, et al. Decreasing pulmonary ventilation through bicarbonate ultrafiltration: an experimental study
. Crit Care Med
. 2009
;37
(9
):2612
–8
. 47.
Russ
M
, Deja
M
, Ott
S
, Bedarf
J
, Keckel
T
, Hiebl
B
, et al. Experimental high-volume hemofiltration with predilutional tris-hydroxymethylaminomethane for correction of low tidal volume ventilation-induced acidosis
. Artif Organs
. 2011
;35
(6
):E108
–118
. 48.
Zanella
A
, Mangili
P
, Giani
M
, Redaelli
S
, Scaravilli
V
, Castagna
L
, et al. Extracorporeal carbon dioxide removal through ventilation of acidified dialysate: an experimental study
. J Heart Lung Transplant
. 2014
;33
(5
):536
–41
. 49.
Godet
T
, Combes
A
, Zogheib
E
, Jabaudon
M
, Futier
E
, Slutsky
AS
, et al. Novel CO2 removal device driven by a renal-replacement system without hemofilter. A first step experimental validation
. Anaesth Crit Care Pain Med
. 2015
;34
(3
):135
–40
. 50.
Scaravilli
V
, Kreyer
S
, Linden
K
, Belenkiy
S
, Pesenti
A
, Zanella
A
, et al. Enhanced extracorporeal CO2 removal by regional blood acidification: effect of infusion of three metabolizable acids
. ASAIO J
. 2015
;61
(5
):533
–9
. 51.
Zanella
A
, Castagna
L
, Salerno
D
, Scaravilli
V
, Abd El Aziz El Sayed Deab
S
, Magni
F
, et al. Respiratory electrodialysis. A novel, highly efficient extracorporeal CO2 removal technique
. Am J Respir Crit Care
. 2015
;192
(6
):719
–26
. 52.
Sharma
AS
, Weerwind
PW
, Bekers
O
, Wouters
EM
, Maessen
JG
. Carbon dioxide dialysis in a swine model utilizing systemic and regional anticoagulation
. Intensive Care Med Exp
. 2016
;4
(1
):2
. 53.
Zanella
A
, Mangili
P
, Redaelli
S
, Scaravilli
V
, Giani
M
, Ferlicca
D
, et al. Regional blood acidification enhances extracorporeal carbon dioxide removal: a 48-hour animal study
. Anesthesiology
. 2014
;120
(2
):416
–24
. 54.
Arazawa
DT
, Kimmel
JD
, Finn
MC
, Federspiel
WJ
. Acidic sweep gas with carbonic anhydrase coated hollow fiber membranes synergistically accelerates CO2 removal from blood
. Acta Biomater
. 2015
;25
:143
–9
. 55.
Ronco
C
, Bellomo
R
, Lonneman
G
. Sepsis: theory and therapies
. N Engl J Med
. 2003 Apr 17
;348
(16
):1600
–2
. 56.
Ronco
C
, Tetta
C
, Mariano
F
, Wratten
ML
, Bonello
M
, Bordoni
V
, et al. Interpreting the mechanisms of continuous renal replacement therapy in sepsis: the peak concentration hypothesis
. Artif Organs
. 2003
;27
(9
):792
–801
. 57.
FDA approval document. Available from:
https://www.fda.gov/medical-devices/emergency-situations-medical-devices/emergency-use-authorizations.58.
Peng
ZY
, Bishop
JV
, Wen
XY
, Elder
MM
, Zhou
F
, Chuasuwan
A
, et al. Modulation of chemokine gradients by apheresis redirects leukocyte trafficking to different compartments during sepsis, studies in a rat model
. Crit Care
. 2014
;18
:R141
. 59.
Kellum
JA
, Pike
F
, Yealy
DM
, Huang
DT
, Shapiro
NI
, Angus
DC
, et al. Relationship between alternative resuscitation strategies, host response and injury biomarkers, and outcome in septic shock: analysis of the protocol-based care for early septic shock study
. Crit Care Med
. 2017
;45
(3
):438
–45
. 60.
Rimmelé
T
, Kaynar
AM
, McLaughlin
JN
, Bishop
JV
, Fedorchak
MV
, Chuasuwan
A
, et al. Leukocyte capture and modulation of cell-mediated immunity during human sepsis: an ex vivo study
. Crit Care
. 2013
;17
:R59
. 61.
Yekebas
EF
, Eisenberger
CF
, Ohnesorge
H
, Saalmüller
A
, Elsner
HA
, Engelhardt
M
, et al. Attenuation of sepsis-related immunoparalysis by continuous veno-venous hemofiltration in experimental porcine pancreatitis
. Crit Care Med
. 2001
;29
:1423
–30
. 62.
Joannes-Boyau
O
, Honoré
PM
, Perez
P
, Bagshaw
SM
, Grand
H
, Canivet
JL
, et al. High-volume versus standard-volume haemofiltration for septic shock patients with acute kidney injury (IVOIRE study): a multicentre randomized controlled trial
. Intensive Care Med
. 2013
;39
:1535
–46
. 63.
Quenot
JP
, Binquet
C
, Vinsonneau
C
, Barbar
SD
, Vinault
S
, Deckert
V
, et al. Very high volume hemofiltration with the Cascade system in septic shock patients
. Intensive Care Med
. 2015
;41
:2111
–20
. 64.
Mao
HJ
, Yu
S
, Yu
XB
, Zhang
B
, Zhang
L
, Xu
XR
, et al. Effects of coupled plasma filtration adsorption on immune function of patients with multiple organ dysfunction syndrome
. Int J Artif Organs
. 2009
;32
:31
–8
. 65.
Busund
R
, Koukline
V
, Utrobin
U
, Nedashkovsky
E
. Plasmapheresis in severe sepsis and septic shock: a prospective, randomised, controlled trial
. Intensive Care Med
. 2002
;28
:1434
–9
. 66.
Zhou
F
, Peng
Z
, Murugan
R
, Kellum
JA
. Blood purification and mortality in sepsis: a meta-analysis of randomized trials
. Crit Care Med
. 2013
;41
:2209
–20
. 67.
Cruz
DN
, Antonelli
M
, Fumagalli
R
, Foltran
F
, Brienza
N
, Donati
A
, et al. Early use of polymyxin B hemoperfusion in abdominal septic shock: the EUPHAS randomized controlled trial
. JAMA
. 2009
;301
:2445
–52
. 68.
Payen
DM
, Guilhot
J
, Launey
Y
, Lukaszewicz
AC
, Kaaki
M
, Veber
B
, et al. Early use of polymyxin B hemoperfusion in patients with septic shock due to peritonitis: a multicenter randomized control trial
. Intensive Care Med
. 2015
;41
:975
–84
. 69.
Dellinger
RP
, Bagshaw
SM
, Antonelli
M
, Foster
DM
, Klein
DJ
, Marshall
JC
, et al. Effect of targeted polymyxin B hemoperfusion on 28-day mortality in patients with septic shock and elevated endotoxin level: the EUPHRATES randomized clinical trial
. JAMA
. 2018
;320
:1455
–63
. 70.
Klein
DJ
, Foster
D
, Walker
PM
, Bagshaw
SM
, Mekonnen
H
, Antonelli
M
. Polymyxin B hemoperfusion in endotoxemic septic shock patients without extreme endotoxemia: a post hoc analysis of the EUPHRATES trial
. Intensive Care Med
. 2018
;44
(12
):2205
–12
. 71.
Schädler
D
, Pausch
C
, Heise
D
, Meier-Hellmann
A
, Brederlau
J
, Weiler
N
, et al. The effect of a novel extracorporeal cytokine hemoadsorption device on IL-6 elimination in septic patients: a randomized controlled trial
. PLoS One
. 2017
;12
:e0187015
. 72.
Poli
EC
, Alberio
L
, Bauer-Doerries
A
, Marcucci
C
, Roumy
A
, Kirsch
M
, et al. Cytokine clearance with Cytosorb during cardiac surgery: a pilot randomized controlled trial
. Crit Care
. 2019
;23
(1
):108
. 73.
Malard
B
, Lambert
C
, Kellum
JA
. In vitro comparison of the adsorption of inflammatory mediators by blood purification devices
. Intensive Care Med Exp
. 2018
;6
:12
. 74.
Atan
R
, Peck
L
, Visvanathan
K
, Skinner
N
, Eastwood
G
, Bellomo
R
, et al. High cut-off hemofiltration versus standard hemofiltration: effect on plasma cytokines
. Int J Artif Organs
. 2016
;39
:479
–86
. 75.
Atan
R
, Peck
L
, Prowle
J
, Licari
E
, Eastwood
GM
, Storr
M
, et al. A double-blind randomized controlled trial of high cutoff versus standard hemofiltration in critically ill patients with acute kidney injury
. Crit Care Med
. 2018
;46
:e988
–94
. 76.
Chu
L
, Li
G
, Yu
Y
, Bao
X
, Wei
H
, Hu
M
. Clinical effects of hemoperfusion combined with pulse high-volume hemofiltration on septic shock
. Medicine
. 2020 Feb
;99
(9
):e19058
. 77.
Kaçar
CK
, Uzundere
O
, Kandemir
D
, Yektaş
A
. Efficacy of HA330 hemoperfusion adsorbent in patients followed in the intensive care unit for septic shock and acute kidney injury and treated with continuous venovenous hemodiafiltration as renal replacement therapy
. Blood Purif
. 2020 Jan 28
:1
–9
. 78.
Guan
WJ
, Ni
ZY
, Hu
Y
, Liang
WH
, Ou
CQ
, He
JX
. et al. Clinical characteristics of coronavirus disease 2019 in China
. N Engl J Med
. 2020
;3
(5
):e208292
. 79.
Wu
C
, Chen
X
, Cai
Y
, Xia
J
, Zhou
X
, Xu
S
, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China
. JAMA Intern Med
. 2020
. 80.
Panitchote
A
, Mehkri
O
, Hastings
A
, Hanane
T
, Demirjian
S
, Torbic
H
, et al. Factors associated with acute kidney injury in acute respiratory distress syndrome
. Ann Intensive Care
. 2019
;9
:74
. 81.
Husain-Syed
F
, Slutsky
AS
, Ronco
C
. Lung-kidney cross-talk in the critically Ill patient
. Am J Respir Crit Care Med
. 2016
;194
:402
–14
. 82.
Huang
C
, Wang
Y
, Li
X
, Ren
L
, Zhao
J
, Hu
Y
. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China
. Lancet
. 2020
;395
;497
–506
. 83.
Ronco
C
, Reis
T
, De Rosa
S
. Coronavirus epidemic and extracorporeal therapies in intensive care: si vis pacem para bellum
. Blood Purif
. 2020
;49
(3
);255
–8
. 84.
Girardot
T
, Schneider
A
, Rimmelé
T
. Blood purification techniques for sepsis and septic AKI
. Semin Nephrol
. 2019
;39
:505
–14
. 85.
Bell
M
, Broman
M
, Joannes-Boyau
O
, Ronco
C
. Comparison of the accuracy of the novel PrisMax continuous renal replacement therapy system to the classic prismaflex system
. Blood Purif
. 2019
;47
(1–3
):166
–70
. 86.
Ronco
C
, Clark
WR
. Haemodialysis membranes
. Nat Rev Nephrol
. 2018 Jun
;14
(6
):394
–410
. 87.
Ronco
C
, Marchionna
N
, Brendolan
A
, Neri
M
, Lorenzin
A
, Martínez Rueda
AJ
. Expanded haemodialysis: from operational mechanism to clinical results
. Nephrol Dial Transplant
. 2018 Oct 1
;33
(Suppl l_3
):iii41
–7
. 88.
Romagnoli
S
, Ricci
Z
, Ronco
C
. CRRT for sepsis-induced acute kidney injury
. Curr Opin Crit Care
. 2018 Dec
;24
(6
):483
–92
. 89.
Clark
WR
, Neri
M
, Garzotto
F
, Goldstein
SL
, Ricci
Z
, Ronco
C
. The future of critical care: renal support in 2027
. Crit Care
. 2017
;21
:92
. © 2020 S. Karger AG, Basel
2020
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