Use of Hemadsorption in a Case of Pediatric Toxic Shock Syndrome

Table 1

Laboratory parameters during the course of multiple immune-modulatory therapies including CVVHD + CytoSorb.

Time from admission	pH	Lactate; mmol/L	CRP; mg/L	PCT; μg/L	WBC; 10^3/μL	Platelets; 10^3/μL	BUN; mmol/L	Creatinine; μmol/L	ALT; U/L	AST; U/L	LDH; U/L
0	6,42	8.6	178.7	218.4	14.97	204	10.5	196	38	21	344
6 hr	Start of hydrocortisone, IVIG
15 hr	7.35	4.4	114	95.07	8.67	67	11.1	134	—	—	—
42 hr	7.37	3.9	105.1	32.85	7.72	34	17.3	147	—	—	—
63 hr	7.39	3.6	113.5	20.54	8.15	12	24.3	210	—	—	—
67 hr	Start of plasma exchange therapy
69 hr	7.39	4.2	87.46	19.02	6.96	21	26.4	223	270	150	887
78 hr	Start of CVVHD-CytoSorb
91 hr	7.41	1.9	50.5	4.06	1.91	5	18.8	163	214	101	554
133 hr	7.47	1.5	87.46	3.33	4.31	5	12.8	98	274	146	676
150 hr	End of CVVHD-CytoSorb
212 hr	7.39	0.7	76.01	2.8	3.78	20	7.6	78	78	94	587

CRP: C-reactive protein, PCT: procalcitonin, WBC: white blood cell, BUN: blood urea nitrogen, ALT: alanine aminotransferase, AST: aspartate aminotransferase, LDH: lactate dehydrogenase, IVIG: intravenous immune globulin, and CVVHD: continuous venovenous hemodialysis. Normal values of laboratory results provided by the examiner institution: lactate: 0,5–2,2 mmol/L, CRP: <2,2 mg/L, PCT: 0,5 μg/L, WBC: 4,5–11,5 G/L, platelets: 150–500 G/L, BUN: 1,8–6,4 mmol/L, creatinine: 18–53 mmol/L, ALT: <40 U/L, AST: <40 U/L, and LDH: <340 U/L.