Efficiency and safety of total plasma exchange in critically ill cirrhotic patients with acute on chronic liver failure: A pilot study

医学 失代偿 内科学 沙发评分 肝移植 胃肠病学 胆红素 前瞻性队列研究 肝功能 病危 白蛋白 肝硬化 人工肝 病因学 外科 肝衰竭 移植
作者
Ilias Kounis,Sophie‐Caroline Sacleux,Marie Amelie Ordan,Stéphane André,Marc Boudon,Audrey Coilly,Rodolphe Sobesky,Eléonora De Martin,Didier Samuel,Philippe Ichaı̈,Faouzi Saliba
出处
期刊:Clinics and Research in Hepatology and Gastroenterology [Elsevier BV]
卷期号:47 (8): 102206-102206 被引量:2
标识
DOI:10.1016/j.clinre.2023.102206
摘要

Treatment of patients with acute on chronic liver failure (ACLF) admitted to the ICU is very limited. The aim of this pilot study was to evaluate the efficiency on liver function and safety of therapeutic plasma exchange (TPE) in critically ill cirrhotic patients admitted with ACLF in a liver ICU. This is a prospective cohort of patients with ACLF grade > 2 treated by TPE admitted to the ICU that was matched to a control group. TPE was performed using a plasma filter (TPE2000, BAXTER®) on a CRRT machine (Prismaflex®, Baxter®). Ratio and type of fluid replacement were 50% with 5% albumin solution followed by 50% with fresh frozen plasma. Seven patients with a mean age of 50.6 ± 7.8 years (all males) and 14 controls matched to age, sex, etiology and cause of decompensation were recruited. At ICU admission, mean MELD score was 39.1 ± 2.7, mean SOFA score was 11.6 ± 5.2 and mean CLIF SOFA score was 12.9 ± 2.6. The grade of ACLF was 3 for 3 patients (42.9%) and 2 for 4 patients (57.1%). The TPE group had significantly higher levels of bilirubin (392.3 ± 117.1 vs. 219 ± 185, p = 0.04), and INR values (5.7 ± 3.4 vs. 3.5 ± 0.9, p < 0.005) compared to the control group. Patient survival was respectively 28.6% and 14.3% at 30 and 90 days in the TPE group and 35.7% and 7.14% in the control group respectively (HR: 1 (95% CI 0.19- 5.2; p = 1). One patient in the TPE group had a liver transplantation 13 days after admission to ICU and is still alive and none in the control group. Two (28.6%) patients died from complications related to the double lumen catheter used for TPE. This pilot study of TPE in patients with ACLF grade 2 and 3 showed a marked but transient improvement in liver function tests. TPE worth to be evaluated in large trials in ACLF patients, with a liver transplant project, and less organ failure.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
昏睡的蟠桃应助kakafan采纳,获得80
刚刚
刚刚
1秒前
宁静致远发布了新的文献求助10
1秒前
1秒前
2秒前
orixero应助A拉拉拉采纳,获得10
2秒前
2秒前
脑洞疼应助酷酷妙梦采纳,获得10
3秒前
Lan完成签到 ,获得积分10
3秒前
清若静发布了新的文献求助10
3秒前
AIMS发布了新的文献求助10
3秒前
4秒前
kaida发布了新的文献求助10
4秒前
zss发布了新的文献求助20
6秒前
7秒前
Singularity应助Bob采纳,获得10
7秒前
风华正茂发布了新的文献求助30
7秒前
hhh发布了新的文献求助10
7秒前
千秋梧完成签到,获得积分10
7秒前
兴奋大船完成签到,获得积分10
8秒前
瘦瘦的迎南完成签到 ,获得积分10
8秒前
咚咚发布了新的文献求助10
8秒前
水天完成签到,获得积分10
10秒前
10秒前
10秒前
吃点红糖馒头完成签到,获得积分10
10秒前
10秒前
11秒前
过江春雷完成签到,获得积分10
11秒前
SYLH应助猪猪hero采纳,获得10
12秒前
水天发布了新的文献求助10
13秒前
13秒前
Jasper应助highwind采纳,获得10
14秒前
伟卫完成签到,获得积分10
14秒前
野猪大王完成签到 ,获得积分10
14秒前
14秒前
14秒前
norberta发布了新的文献求助10
15秒前
烟花应助111采纳,获得30
15秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
A new approach to the extrapolation of accelerated life test data 1000
徐淮辽南地区新元古代叠层石及生物地层 500
Robot-supported joining of reinforcement textiles with one-sided sewing heads 400
北师大毕业论文 基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 390
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4023175
求助须知:如何正确求助?哪些是违规求助? 3563272
关于积分的说明 11341846
捐赠科研通 3294815
什么是DOI,文献DOI怎么找? 1814780
邀请新用户注册赠送积分活动 889460
科研通“疑难数据库(出版商)”最低求助积分说明 812964