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Intensive Care Medicine
Published in: Intensive Care Medicine 11/2005

01-11-2005 | Original

The effect of molecular adsorbent recirculating system on pathophysiological parameters in patients with acute liver failure

Authors: Wai Kwan Lai, Geoff Haydon, David Mutimer, Nick Murphy

Published in: Intensive Care Medicine | Issue 11/2005

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Abstract

Objective

To investigate the effect of the molecular adsorbent recirculating system (MARS) on physiological variables in patients with acute liver failure.

Design

A prospective, observational study of MARS in addition to standard medical therapy in the management of patients presenting with acute liver failure.

Setting

A regional liver transplant centre.

Patients

Ten consecutive patients admitted with acute liver failure with a grade III or IV hepatic encephalopathy.

Interventions

MARS therapy for 8 h on 2 consecutive days. Standard monitoring included the use of a pulmonary artery catheter and an intracranial pressure monitor.

Measurements and results

During the first MARS treatment there was a significant increase in systemic vascular resistance index (SVRI) from 1114±196 to 1432±245 dyne s−1 cm−5m−2 with a reduction in cardiac index from 5.5±0.6 to 4.2±0.4 l min−1 m−2. The changes were maintained between the start of the first and second sessions but not to the end of second. Significant clearance of urea and creatinine was observed. Intracranial pressure did not change during the treatments. Overall mortality was 70%.

Conclusions

MARS therapy was well tolerated, with significant increases in vascular tone during the first session. This increase was not sustained over the duration of the study with a return to baseline values by the end of the second session. Based on our experience we cannot recommend the routine use of MARS therapy in acute liver failure outside of a clinical trial.
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Metadata
Title
The effect of molecular adsorbent recirculating system on pathophysiological parameters in patients with acute liver failure
Authors
Wai Kwan Lai
Geoff Haydon
David Mutimer
Nick Murphy
Publication date
01-11-2005
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 11/2005
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-005-2786-y

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