{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:30:14Z","timestamp":1789003814422,"version":"build-2803163510"},"reference-count":29,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T00:00:00Z","timestamp":1601251200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Artif Organs"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:p>\n                    A substantial part of COVID-19-patients suffers from multi-organ failure (MOF). We report on an 80-year old patient with pulmonary, renal, circulatory, and hepatic failure. We decided against the use of extracorporeal membrane oxygenation (ECMO) due to old age and a SOFA-score of 13. However, the patient was continuously treated with the extracorporeal multi-organ- \u201cADVanced Organ Support\u201d (ADVOS) device (ADVITOS GmbH, Munich, Germany). During eight 24h-treatment-sessions blood flow (100\u2013300\u2009mL\/min), dialysate flow (160\u2013320\u2009mL\/min) and dialysate pH (7.6\u20139.0) were adapted to optimize arterial PaCO\n                    <jats:sub>2<\/jats:sub>\n                    and pH. Effective CO\n                    <jats:sub>2<\/jats:sub>\n                    removal and correction of acidosis could be demonstrated by mean arterial- versus post-dialyzer values of pCO\n                    <jats:sub>2<\/jats:sub>\n                    (68.7\u2009\u00b1\u200913.8 vs. 26.9\u2009\u00b1\u200911.6\u2009mmHg; p\u2009&lt;\u20090.001). The CO\n                    <jats:sub>2<\/jats:sub>\n                    -elimination rate was 48\u2009\u00b1\u200923mL\/min. The initial vasopressor requirement could be reduced in parallel to pH-normalization. Interruptions of ADVOS-treatment repeatedly resulted in reversible deteriorations of p\n                    <jats:sub>a<\/jats:sub>\n                    CO\n                    <jats:sub>2<\/jats:sub>\n                    and pH. After 95\u2009h of continuous extracorporeal decarboxylating therapy the patient had markedly improved circulatory parameters compared to baseline. In the context of secondary pulmonary infection and progressive liver failure, the patient had a sudden cardiac arrest. In accordance with the presumed patient will, we decided against mechanical resuscitation. Irrespective of the outcome we conclude that extracorporeal CO\n                    <jats:sub>2<\/jats:sub>\n                    removal and multiorgan-support were feasible in this COVID-19-patient. Combined and less invasive approaches such as ADVOS might be considered in old-age-COVID-19 patients with MOF.\n                  <\/jats:p>","DOI":"10.1177\/0391398820961781","type":"journal-article","created":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T05:59:03Z","timestamp":1601272743000},"page":"288-294","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Extracorporeal multiorgan support including CO\n                    <sub>2<\/sub>\n                    -removal with the ADVanced Organ Support (ADVOS) system for COVID-19: A case report"],"prefix":"10.1177","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9086-7908","authenticated-orcid":false,"given":"Wolfgang","family":"Huber","sequence":"first","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Lorenz","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"},{"name":"Abteilung f\u00fcr Nephrologie, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Heilmaier","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"B\u00f6ttcher","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Sahm","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Middelhoff","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Ritzer","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7134-5706","authenticated-orcid":false,"given":"Dominik","family":"Schulz","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9958-7769","authenticated-orcid":false,"given":"Elias","family":"Bekka","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Hesse","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Poszler","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1545-485X","authenticated-orcid":false,"given":"Fabian","family":"Geisler","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3875-5367","authenticated-orcid":false,"given":"Christoph","family":"Spinner","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland M","family":"Schmid","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Lahmer","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, Klinikum rechts der Isar der Technischen Universit\u00e4t M\u00fcnchen, M\u00fcnchen, 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