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Bleeding complications associated with the molecular adsorbent recirculating system: a retrospective study
BACKGROUND: The molecular adsorbent recirculating system (MARS) is a hepatic replacement system that supports excretory liver function in patients with liver failure. However, since MARS has been employed in our hospital, bleeding complications have occurred in many patients during or after MARS. Th...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Korean Society of Critical Care Medicine
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8907459/ https://www.ncbi.nlm.nih.gov/pubmed/35263827 http://dx.doi.org/10.4266/acc.2021.00276 |
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author | Yoo, Seon Woo Ki, Min-Jong Kim, Dal Kim, Seul Ki Park, SeungYong Han, Hyo Jin Lee, Heung Bum |
author_facet | Yoo, Seon Woo Ki, Min-Jong Kim, Dal Kim, Seul Ki Park, SeungYong Han, Hyo Jin Lee, Heung Bum |
author_sort | Yoo, Seon Woo |
collection | PubMed |
description | BACKGROUND: The molecular adsorbent recirculating system (MARS) is a hepatic replacement system that supports excretory liver function in patients with liver failure. However, since MARS has been employed in our hospital, bleeding complications have occurred in many patients during or after MARS. The objective of this study was to determine how MARS affects coagulopathy and identify specific factors associated with bleeding complications. METHODS: We retrospectively analyzed data from 17 patients undergoing a total of 41 MARS sessions. Complete blood count, coagulation profiles, and blood chemistry values were compared before and after MARS. To identify pre-MARS factors associated with increased bleeding after MARS, we divided patients into bleeder and non-bleeder groups and compared their pre-MARS laboratory values. RESULTS: MARS significantly reduced bilirubin and creatinine levels. MARS also increased prothrombin time and reduced platelet and fibrinogen, thus negatively impacting coagulation. Pre-MARS hemoglobin was significantly lower in the bleeder group than in the non-bleeder group (P=0.015). When comparing the upper and lower 33% of MARS sessions based on the hemoglobin reduction rate, hemoglobin reduction was significantly greater in MARS sessions involving patients with low pre-MARS international normalized ratio of prothrombin time (PT-INR) and factor V (P=0.038 and P=0.023, respectively). CONCLUSIONS: MARS could appears to alter coagulation-related factors such as factor V and increase the risk of bleeding complications particularly in patient with low hemoglobin. However, individual differences among patients were large, and various factors, such as low hemoglobin, PT-INR, and factor V levels, appear to be involved. |
format | Online Article Text |
id | pubmed-8907459 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Korean Society of Critical Care Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-89074592022-03-16 Bleeding complications associated with the molecular adsorbent recirculating system: a retrospective study Yoo, Seon Woo Ki, Min-Jong Kim, Dal Kim, Seul Ki Park, SeungYong Han, Hyo Jin Lee, Heung Bum Acute Crit Care Original Article BACKGROUND: The molecular adsorbent recirculating system (MARS) is a hepatic replacement system that supports excretory liver function in patients with liver failure. However, since MARS has been employed in our hospital, bleeding complications have occurred in many patients during or after MARS. The objective of this study was to determine how MARS affects coagulopathy and identify specific factors associated with bleeding complications. METHODS: We retrospectively analyzed data from 17 patients undergoing a total of 41 MARS sessions. Complete blood count, coagulation profiles, and blood chemistry values were compared before and after MARS. To identify pre-MARS factors associated with increased bleeding after MARS, we divided patients into bleeder and non-bleeder groups and compared their pre-MARS laboratory values. RESULTS: MARS significantly reduced bilirubin and creatinine levels. MARS also increased prothrombin time and reduced platelet and fibrinogen, thus negatively impacting coagulation. Pre-MARS hemoglobin was significantly lower in the bleeder group than in the non-bleeder group (P=0.015). When comparing the upper and lower 33% of MARS sessions based on the hemoglobin reduction rate, hemoglobin reduction was significantly greater in MARS sessions involving patients with low pre-MARS international normalized ratio of prothrombin time (PT-INR) and factor V (P=0.038 and P=0.023, respectively). CONCLUSIONS: MARS could appears to alter coagulation-related factors such as factor V and increase the risk of bleeding complications particularly in patient with low hemoglobin. However, individual differences among patients were large, and various factors, such as low hemoglobin, PT-INR, and factor V levels, appear to be involved. Korean Society of Critical Care Medicine 2021-11 2021-11-16 /pmc/articles/PMC8907459/ /pubmed/35263827 http://dx.doi.org/10.4266/acc.2021.00276 Text en Copyright © 2021 The Korean Society of Critical Care Medicine https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Yoo, Seon Woo Ki, Min-Jong Kim, Dal Kim, Seul Ki Park, SeungYong Han, Hyo Jin Lee, Heung Bum Bleeding complications associated with the molecular adsorbent recirculating system: a retrospective study |
title | Bleeding complications associated with the molecular adsorbent recirculating system: a retrospective study |
title_full | Bleeding complications associated with the molecular adsorbent recirculating system: a retrospective study |
title_fullStr | Bleeding complications associated with the molecular adsorbent recirculating system: a retrospective study |
title_full_unstemmed | Bleeding complications associated with the molecular adsorbent recirculating system: a retrospective study |
title_short | Bleeding complications associated with the molecular adsorbent recirculating system: a retrospective study |
title_sort | bleeding complications associated with the molecular adsorbent recirculating system: a retrospective study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8907459/ https://www.ncbi.nlm.nih.gov/pubmed/35263827 http://dx.doi.org/10.4266/acc.2021.00276 |
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