Effectiveness of Combining Plasma Exchange With Continuous Hemodiafiltration on Acute Fatty Liver of Pregnancy Complicated by Multiple Organ Dysfunction
| Autor: | Hong-sheng Ren, Juan Zeng, Jin-jiao Jiang, Hai-Yan Zhou, Mei Meng, Ji-cheng Zhang, Chunting Wang, Wenying Zhu, Yu-feng Chu |
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| Rok vydání: | 2012 |
| Předmět: |
medicine.medical_specialty
Pregnancy business.industry Septic shock Organ dysfunction Encephalopathy Biomedical Engineering Medicine (miscellaneous) Bioengineering General Medicine medicine.disease Intensive care unit Acute fatty liver of pregnancy Surgery law.invention Biomaterials law Anesthesia Coagulopathy medicine medicine.symptom business Rare disease |
| Zdroj: | Artificial Organs. 36:530-534 |
| ISSN: | 0160-564X |
| DOI: | 10.1111/j.1525-1594.2011.01424.x |
| Popis: | Acute fatty liver of pregnancy (AFLP) is a rare disease of progressive hepatic insufficiency and secondary systemic complications that induce significant maternal risk. The application of combining plasma exchange (PE) and continuous hemodiafiltration (CHDF) is a novel concept for patients with AFLP. Since 2002, we have utilized the combination of PE with CHDF as adjunctive medical therapy for 11 AFLP patients with multiple organ dysfunction. Before PE and CHDF initiation, four patients had signs and symptoms of encephalopathy, four required ventilatory support, and all 11 were developing liver failure, significant renal compromise, and coagulopathy. PE combined with CHDF for patients was initiated a mean of 2 days postpartum (range, days 0-3). Daily or every other day PE combined with CHDF was undertaken on two to eight occasions for each of the 11 patients. Ten patients responded with composite clinical and laboratory improvement and were discharged to the ward, then cured and discharged from hospital; one patient died of septic shock. Average duration of hospitalization was 17 days (range, days 9-38) from time of admission to discharge; the average duration of intensive care unit was 10 days (range, days 4-23). No significant PE- and CHDF-related complications occurred. These results indicate that combing PE and CHDF in a series-parallel circuit is an effective and safe treatment for patients with severe AFLP. This finding may have important implications for the development of an effective treatment for patients with AFLP suffering multiple organ dysfunction. |
| Databáze: | OpenAIRE |
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