Page 16 - SFHN JUNE 2020 FLIP BOOK

UM Offers Stem Cells to Treat COVID-19 Patients

with Life-Threatening Respiratory Infections

For COVID-19 patients in severe respi- a “cytokine storm,” referring to small
ratory distress, the University of Miami proteins that produce inflammation,
Miller School of Medicine now offers damaging the lungs and other organs.
access to mesenchymal stem cell (MSC) “Stem cells don’t make the virus disap-
treatments that may help fight the char- pear, but they help the body fight this
acteristic inflammation that accompanies disease,” said Khan. “By suppressing the
the viral infection. cytokine storm, they can help a patient
On April 5, the U.S. Food and Drug regain breathing ability.”
Administration (FDA) approved MSC On April 7, Sixto Alejandro Arias,
treatments for seriously ill COVID-19 M.D., an interventional pulmonologist
patients as an “expanded access compas- with UHealth – the University of Miami
sionate use.” Since then, UM has provid- Health System, gave an initial infusion of
ed clinicians in Miami and Maryland MSCs to a patient in his 40s, who tested
with MSCs taken from bone marrow and positive for COVID-19 in mid-March
cultured at the Interdisciplinary Stem and was admitted to UHealth Tower with
Cell Institute (ISCI) manufacturing lab. severe respiratory problems.
Six COVID-19 patients with serious “Stem cells have been widely used to
breathing difficulties have shown treat interstitial lung disease, and we felt
improvement after receiving MSC infu- this could be a safe and helpful therapy,”
sions along with other treatments. The said Dr. Arias. “He received other forms
sixth patient, who was on ECMO, was of treatment as well; we don’t know how
recently injected at Jackson Memorial much the MSCs helped his condition.
Hospital. But we are very gratified to see him
“Early reports from China indicated improve, and he is now out of intensive
that MSCs could be helpful in treating care.” That patient has since been dis-
COVID-19 patients in severe respiratory charged from UHealth Tower. Dr. Ketty Bacallao retrieves stem cells for patient treatment
distress,” said Jose Guillermo Castro, In early April, ISCI shipped MSCs to from a liquid nitrogen storage tank.
M.D., professor of infectious diseases at clinicians at the University of Maryland
the Miller School and director of the who were treating two patients with no patients,” said Joshua M. Hare, M.D., Cell Transplant Center that will test the
antibiotic stewardship program at other options. Both initial patients and Louis Lemberg Professor of Medicine safety and effectiveness of umbilical
UHealth Tower. “We offer that form of two additional patients did well, and and founding director of ISCI. cord-derived MSCs. “Our staff members
therapy through ISCI and are cautiously their levels of inflammation went down, Khan said ISCI is making both bone are working night and day to build our
optimistic that it can be helpful.” according to Khan. marrow and umbilical cord-derived inventory, and we now have the ability to
Aisha Khan, executive director of labo- “We are so pleased to be able to offer MSCs available for treating COVID-19 treat about 50 patients,” Khan said. “We
ratory operations at ISCI, said MSCs can this experimental therapy, working patients throughout South Florida. The plan to continue growing our inventory
help address an immune system over- closely with our colleagues on the front FDA recently approved a clinical trial led because the need for COVID-19 treat-
response to a COVID-19 infection called lines taking care of these critically ill by UM’s Diabetes Research Institute and ments is so great.”

Ultraviolet Light Exposes Contagion Spread from Improper PPE Use

Despite the use of personal protective To detect contamination, Patrick G. In addition, the researchers added the ed an exposure to the contagion and
equipment (PPE), reports show that Hughes, D.O., lead author, director of fluorescent solution to a simulated indicated that they made an error while
many health care workers contracted the FAU’s emergency medicine simulation albuterol nebulizer treatment, which putting on or taking off their PPE.
coronavirus disease (COVID-19), which program and an assistant professor of was given to the mannequins during the Results from the experiment revealed
raises substantial concerns about the Integrated Medical Science, FAU’s scenario (not in a negative pressure that the most common error made by
effectiveness of the PPE. Highly sought Schmidt College of Medicine, and col- room). the health care staff was contaminating
after PPE used in hospitals and other laborators, used a nontoxic fluorescent After completing the simulated case, the face or forearms during PPE
health care settings is critical in ensuring solution during a PPE training session the health care staff remained in their removal. In contrast, those who put on
the safety of those on the frontline of for health care staff. They placed a high- PPE and were taken to another room, and took off their PPE according to
COVID-19, but only if they are used lighter refill in a warm water bath for 15 where the lights were turned off prior to guidelines had no signs of the fluores-
properly. minutes to create a fluorescent solution, removing their PPE. Turning off the cent contagion on their skin or face.
A physician from Florida Atlantic which is only visible under ultraviolet lights enabled the identification of wide- “This training method allows educa-
University’s Schmidt College of light. spread simulated contagion on the PPE, tors and learners to easily visualize any
Medicine and collaborators from the For the experiment, published in the both on the gloves and gowns from contamination on themselves after they
University of Arizona College of journal Medical Education, the directly touching the simulated patient fully remove their personal protective
Medicine -Tucson and the Indiana researchers instructed health care staff to and on the face shields and masks from equipment,” said Hughes. “We can make
University School of Medicine conduct- put on PPE, which included a cap, the aerosolized solution. The researchers immediate corrections to each individ-
ed a novel training technique to rein- gown, surgical gloves, eye protection, used a black light flashlight to examine ual’s technique based on visual evidence
force the importance of using proper face shield and N95 mask. In order to each health care worker and to identify of the exposure.”
procedures to put on and take off PPE conserve vital PPE, supplies were wiped the presence of any fluorescent solution. By providing health care staff with
when caring for patients during the pan- off and reused for multiple trainings. Following the flashlight examination, visual evidence of protection during
demic. Researchers were able to vividly After health care staff in the study put on the health care staff completely removed patient encounters with high-risk
demonstrate how aerosol-generating their PPE, they went in to a room to care their PPE. Researchers discovered the aerosol-generating procedures, this
procedures can lead to exposure of the for a simulated patient sprayed down presence of fluorescent solution on the innovative training method is helping to
contagion with improper use of PPE. with the invisible simulated contagion. health care staff’s skin, which represent- inspire trust in their training and PPE.

16 June 2020 southfloridahospitalnews.com South Florida Hospital News