An evaluation of the usefulness of extracorporeal liver support techniques in patients with severe liver dysfunction

Autor:	Mariusz Piechota, Anna Piechota, Małgorzata Misztal, Szymon Bernas, Iwona Pietraszek-Grzywaczewska
Jazyk:	angličtina
Rok vydání:	2018
Předmět:	fractionated plasma separation and adsorption single pass albumin dialysis sequential organ failure assessment acute physiology and chronic health evaluation ii simplified acute physiology score ii model of end-stage liver disease unos modification Medicine
Zdroj:	Archives of Medical Science, Vol 15, Iss 1, Pp 99-112 (2018)
Druh dokumentu:	article
ISSN:	1734-1922 1896-9151
DOI:	10.5114/aoms.2017.67998
Popis:	Introduction The mortality rate in patients with severe liver dysfunction with no option of transplantation is unacceptably high. The main aim of this study was to evaluate the usefulness of applying extracorporeal liver support (ECLS) techniques in this group of patients. Material and methods Data from hospital admissions of 101 patients with severe liver dysfunction who were admitted to the department of Anaesthesiology and intensive therapy between 2006 and 2015 were retrospectively analysed. The study group was divided into two subgroups. Standard Medical therapy (SMT) was a subgroup of patients receiving standard Medical therapy, and SMT + ECLS was a subgroup containing patients receiving standard medical therapy complemented by at least one extracorporeal liver support procedure. Results Significantly lower intensive care unit (ICU) mortality and 30-day mortality rates were found in the SMT + ECLS subgroup (p = 0.0138 and p = 0.0238 respectively). No difference in 3-month mortality was identified between the two groups. In a multivariate model, independent risk factors for ICU mortality proved to be the SOFA score and prothrombin time. The highest discriminatory power for ICU mortality was demonstrated for the SOFA score, followed by APACHE II, SAPS II, MELD UNOS and GCS scores. For 30-day mortality, however, the best discriminatory power was shown for the SAPS II score, followed by SOFA, APACHE II, MELD UNOS and GCS scores. Conclusions Further studies are needed to assess the contribution of non-biological extracorporeal liver support procedures to a decrease in mortality rates in the population of patients with severe liver dysfunction.
Databáze:	Directory of Open Access Journals
Externí odkaz:	https://doaj.org/article/05db9852157741449067b71feb0b5828 Zobrazit plný text záznamu View record in DOAJ Plný text ve formátu PDF