Is the Molecular Adsorbent Recirculating System the Answer for Children With Acute Liver Failure?

Rosenthal, Philip

doi:10.1002/lt.24045

Cited by 2 publications

(3 citation statements)

References 11 publications

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“…[26,38] However, the albumin loss during Prometheus-therapy can reach 3 g/L (P = 0.055). [31,39] We observed no significant negative dynamics of serum albumin [oscillations: 32 (30-35) and 30 (26)(27)(28)(29)(30)(31)(32)(33)(34)(35) g/L, P = 0.052, before and after MARS-therapy; 33 (31-34) and 31 (28-36) g/L, P = 0.051, before and after Prometheus-therapy], which is probably due to the adequate routine correction of hypoproteinemia in patients with ALF. [39] Likewise, despite published data on the loss of coagulation factors during Prometheus-therapy, [40] we did not observe clinically significant hemorrhagic complications.…”

Section: Extracorporeal Blood Purification In Intensive Care Patientsmentioning

confidence: 84%

“…[30,31] The experience from implementing this therapy in adults allows the use of extracorporeal liver support to be recommended in pediatric practice. [32][33][34] MARS-therapy is a method of albumin dialysis that uses a filter permeable to substances with a molecular weight of up to 50 kDa. The toxins accumulated on the filter membrane are subsequently bound to the donor albumin used as a dialysate.…”

Section: Extracorporeal Blood Purification In Intensive Care Patientsmentioning

confidence: 99%

“…By the end of MARS-therapy, MAP exceeded 25% of the baseline, but the need for inotropic support decreased. [32,33] Due to the large heat loss during extracorporeal blood purification in children, it is important to prevent hypothermia. Hypothermia can lead to cardiac output decrease by peripheral vasospasm and an increase in TPVR and post-load.…”

Section: Extracorporeal Blood Purification In Intensive Care Patientsmentioning

confidence: 99%

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Blood purification in intensive care patients with multiple organ dysfunction syndrome and sepsis after cardiac surgery

Yaroustovsky¹,

Abramyan²,

Komardina³

et al. 2017

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How to cite this article: Yaroustovsky M, Abramyan M, Komardina E, Nazarova H. Blood purification in intensive care patients with multiple organ dysfunction syndrome and sepsis after cardiac surgery. Vessel Plus 2017;1:49-60.Extracorporeal blood purification is becoming increasingly important in intensive therapy for multiple organ dysfunction syndrome (MODS) and sepsis, considering all of their pathophysiological aspects. The results of treatment, particularly in children, considering their anatomical and physiological features, are related to the severity and progression of organ failure, the indications that are found, the choice of method, and the timely initiation of blood purification. Multiple organ support therapy is the aim of introducing and applying blood purification today. Various extracorporeal blood purification techniques directly affect the molecular and electrolyte composition of blood and influence all structures of the human body, which can allow us to correct, recover, replace and maintain homeostasis in MODS. The potential of new extracorporeal molecular technologies allows their successful use in severe cardiac and respiratory failure, acute kidney injury and hepatic dysfunction and in complex therapy for severe infections and sepsis and extreme metabolic violations. Adult and pediatric patients after cardiac surgery with cardiopulmonary bypass form a special cohort that often requires the application of various intra-and extracorporeal techniques due to the development of MODS, infections and sepsis in the postoperative period. Key words:Extracorporeal blood purification, acute kidney injury, acute liver failure, extracorporeal membrane oxygenation, sepsis, selective lipopolysaccharideadsorption, critical condition, cardiovascular surgery ABSTRACT Article history:

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Section: Extracorporeal Blood Purification In Intensive Care Patientsmentioning

confidence: 84%

Section: Extracorporeal Blood Purification In Intensive Care Patientsmentioning

confidence: 99%

Section: Extracorporeal Blood Purification In Intensive Care Patientsmentioning

confidence: 99%

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Blood purification in intensive care patients with multiple organ dysfunction syndrome and sepsis after cardiac surgery

Yaroustovsky¹,

Abramyan²,

Komardina³

et al. 2017

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Methods of Molecular Transfusion in Intensive Care of Critical States in Pediatric Postoperative Cardiac Surgery Patients

2016

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Molecular techniques in transfusion medicine have become popular in the clinical practice of pediatric intensive care units when the patient needs blood purification, more recently, in children in critical condition. Considering the anatomical and physiological characteristics of the child’s body, pronounced severity, and rapid progression of multiple organ disorders, the key problems defining the treatment results are instrument reading, choice and timely initiation of extracorporeal therapy. Today, along with the methods of renal replacement therapy in children albumin dialysis therapy and high-volume plasmapheresis are successfully applied in the treatment of acute liver dysfunction; extracorporeal membrane oxygenation — in the treatment of biventricular cardiac and/or respiratory failure. Selective endotoxin sorption methods (LPS-adsorption) are implemented in the treatment of severe gram-negative sepsis.

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Is the Molecular Adsorbent Recirculating System the Answer for Children With Acute Liver Failure?

Cited by 2 publications

References 11 publications

Blood purification in intensive care patients with multiple organ dysfunction syndrome and sepsis after cardiac surgery

Blood purification in intensive care patients with multiple organ dysfunction syndrome and sepsis after cardiac surgery

Methods of Molecular Transfusion in Intensive Care of Critical States in Pediatric Postoperative Cardiac Surgery Patients

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