Respiratory failure & ventilation
Hemorheological optimization via isovolemic hemodilution in COVID-19 acute respiratory distress syndrome (ARDS) under chronic environmental hypoxia: A pilot proof-of-concept study
Authors' conclusion
Rapid hemorheological optimization via IVHD was feasible, safe, and associated with an exploratory survival signal in high-altitude COVID-19 ARDS, providing a physiological rationale for prospective randomized trials.
Study context
- Population
- Adult lifelong high-altitude residents (elevation 3,640 m) admitted to the ICU with severe COVID-19 ARDS on invasive mechanical ventilation
- Participants
- 30 consecutive patients
- Exposure
- Isovolemic hemodilution (IVHD) vs conventional ICU management
- IVHDn = 7
- Conventional controlsn = 23reference
- Outcome
- Baseline illness severity scores (APACHE II, PaO₂)
- Follow-up
- Baseline
Methodological detailspilot proof-of-concept, consecutive patients
- Pilot proof-of-concept
- Consecutive patients
Main finding
As reported in the abstract
- Comparable
Observational data: associations, not effects.
Further findings
| Outcome | IVHD | Conventional controls | Crude OR (95% CI) | |
|---|---|---|---|---|
| ICU survival71.4% (5/7) vs 8.7% (2/23); Fisher's exact p=0.003 · exploratory | 71.4% | 8.7% | 26.25 (2.9–234.3) | |
| 0.050.21520Crude odds ratio (log scale) |
| Outcome | IVHD | Conventional controls | P value |
|---|---|---|---|
| Admission hematocrit | 59% (range or IQR as printed 55–66) | 52% (range or IQR as printed 36–68) | P = 0.065 |
Hematocrit and hemoglobin in the IVHD group · 72 hours
- Hematocrit (IVHD group)
- 38% (32-46, p=0.015)
- Hemoglobin (IVHD group)
- 11 g/dL (10-15, p=0.015)
Safety
- No procedural adverse events occurred
Original publication
Hemorheological optimization via isovolemic hemodilution in COVID-19 ARDS under chronic environmental hypoxia: A pilot proof-of-concept study. J Crit Care. Published 24 October 2026. doi:10.
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