Impact of Cytokine Adsorption Treatment in Liver Failure
Autor: | Yaman Tokat, Umut Acar, Akın Akbulut, Ercument Yentur, Zafer Gökkaya, Oya Ferah, Mehmet Eren Açık, Özlem Yenidünya |
---|---|
Rok vydání: | 2018 |
Předmět: |
Male
medicine.medical_specialty Resuscitation Continuous Renal Replacement Therapy Bilirubin Hematocrit Fibrinogen Gastroenterology Procalcitonin Sepsis chemistry.chemical_compound Liver Function Tests Ammonia Internal medicine medicine Humans Hyperbilirubinemia Transplantation medicine.diagnostic_test business.industry Organ dysfunction Albumin Middle Aged medicine.disease Treatment Outcome chemistry Cytokines Surgery Female Adsorption medicine.symptom business Liver Failure medicine.drug |
Zdroj: | Transplantation proceedings. 51(7) |
ISSN: | 1873-2623 |
Popis: | Sepsis causes life-threatening organ dysfunction and is the leading cause of morbidity and mortality in critically ill patients worldwide. Mortality rate of sepsis is close to 30% to 50% despite better understanding of the pathophysiology of sepsis, and advances in antimicrobial therapy, resuscitation strategies, and mechanical ventilation. Liver failure is characterized by accumulation of potentially toxic substances in the systemic circulation of the patient. Toxic effects of these molecules can induce cellular injuries leading to multiorgan dysfunction. Hydrophobic unconjugated bilirubin and bile acids, hydrophilic conjugated bilirubin, and ammonium are the main toxins accumulated in liver failure. We carried out cytokine adsorbtion (CytoSorb) procedure with continuous venovenous hemodialysis in 12-hour sessions. The biochemical values of the patients before and after the use of the filter were recorded. The parameters compared were as follows: total bilirubin, direct bilirubin, C-reactive protein, leukocyte, neutrophil, alanine aminotransferase, aspartate aminotransferase, creatinine, colloid oncotic pressure, ammonia, gamma-glutamyl transferase, alkaline phosphatase, procalcitonin, hematocrit, hemoglobin, pH, albumin, international normalized ratio, fibrinogen, lactate dehydrogenase, platelet, temperature, changes in vasoactive medication requirement, temperature. According to these results, cytokine adsorption systems can be considered as an option to lower bilirubin levels in cases of liver failure. Its inability to lower ammonia level is considered a disadvantage compared with other bilirubin-lowering methods. Although further studies are needed to compare different methods, cytokine adsorption systems may be considered in treatment planning as it contributes to the treatment of sepsis and hyperbilirubinemia in liver failure patients with sepsis. |
Databáze: | OpenAIRE |
Externí odkaz: |