Comparison of plasma exchange, double plasma molecular adsorption system, and their combination in treating acute-on-chronic liver failure
| Autor: | Juan Xu, Weibo Guo, Yan Yang, Yajing Lu, Xiju Guo, Jiachang Zhang, Mingmei Liao, Congbo Yin, Fengqing Wu, Hongxing Fan |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Medicine (General) 030204 cardiovascular system & hematology Biochemistry Gastroenterology 03 medical and health sciences Plasma 0302 clinical medicine Artificial liver R5-920 double plasma molecular adsorption system coagulation function Internal medicine Medicine Humans Acute on chronic liver failure In patient Blood Coagulation Aged Retrospective Studies Aged 80 and over Molecular adsorption Plasma Exchange business.industry Coagulation function Biochemistry (medical) Acute-On-Chronic Liver Failure Bilirubin Cell Biology General Medicine bilirubin removal Middle Aged Liver Artificial Survival Rate Liver Nonbiological artificial liver Prothrombin Time 030211 gastroenterology & hepatology Female Adsorption business Retrospective Clinical Research Report |
| Zdroj: | The Journal of International Medical Research Journal of International Medical Research, Vol 48 (2020) |
| ISSN: | 1473-2300 |
| Popis: | Objective Our objective was to compare the effectiveness of nonbiological artificial liver (NBAL) support, particularly short-term (28-day) survival rates, in patients who underwent treatment using double plasma molecular adsorption system (DPMAS), plasma exchange (PE), or combined PE+DPMAS, in addition to comprehensive physical treatment for different stages of acute-on-chronic liver failure (ACLF). Methods We retrospectively reviewed clinical data of 135 patients with ACLF who received NBAL treatment between November 2015 and February 2019. The patients were categorized into PE, DPMAS, and PE+DPMAS groups. Short-term effectiveness of treatment was assessed and compared based on selected clinical findings, laboratory parameters, and liver function markers. Results Coagulation function improved significantly in all groups after treatment. In the PE and PE+DPMAS groups, prothrombin time decreased to different degrees, whereas plasma thromboplastin antecedent increased significantly after treatment. White blood cell counts increased and platelet counts decreased in all groups after treatment. The model for end-stage liver disease score, Child–Pugh grade, systematic inflammatory syndrome score, and sepsis-related organ failure score decreased in all three groups after treatment. Conclusions PE, DPMAS, and PE+DPMAS improved disease indicators in all patients with ACLF. The combined treatment improved the short-term effectiveness of treatment, especially in patients with mild ACLF. |
| Databáze: | OpenAIRE |
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