Seraph® Filter Effectiveness In Treatment Of Circuit-Related Infections On ECMO Patients - A Single Centre Report

Daniel Lovric¹Ivan Situm¹Vanja Nedeljkovic¹Mate Mogus¹Ante Erceg¹Mirabel Mazar¹Slobodan Mihaljevic¹Vedran Premuzic^2,3*

• ¹Klinicki bolnicki centar Zagreb, Zagreb, Croatia
• ²University of Zagreb, Zagreb, Croatia
• ³Klinicki bolnicki centar Zagreb Klinika za unutarnje bolesti, Zagreb, Croatia

INTRODUCTION: Nosocomial infections in patients on ECMO are frequent and associated with worse outcomes. The aim of this study was to analyze the efficacy of Seraph in patients with COVID-19 treated with ECMO in reducing the circuit-related infection and improving clinical outcome. METHODS: In thirteen patients who required ECMO support circuit-related infection was diagnosed either with local signs of infection and positive microbiological samples taken locally, or if there were positive microbiological blood cultures. Hemoadsorption was performed with Seraph 100 in series with the dialyzer for 4-6 hours. Blood cultures were also sampled before and 24 hours after the treatment with Seraph 100. RESULTS: Sterile blood cultures were achieved in 53.8% of all patients. Blood cultures were sterile from fungi (Candida parapsilosis/glabrata) and from Stenotrophomonas malthophilia in all patients and for Klebsiella pneumoniae in 60%, Staphylococcus epidermidis in 75% and Acinetobacter baumanii in 50% of all patients. We observed significant decreases in vasopressors dose, improvement of respiratory parameters and a significant decrease of SOFA score on the first day after Seraph 100 treatments. CONCLUSION: This is the first study on ECMO patients treated with Seraph 100 for circuit-related infections which showed a significant percentage of negative blood cultures after hemadsorption, especially pronounced for fungi and which should be confirmed in multi-centric prospective studies.