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Value of extracorporeal artificial liver support in pediatric acute liver failure: A single-center experience of over 10 years
PURPOSE: Acute liver failure (ALF) is a life-threatening disease characterized by rapid-onset liver dysfunction, coagulopathy, and encephalopathy in patients without chronic liver disease. Today, the combined application of continuous veno-venous hemodiafiltration (CVVHDF) and plasma exchange (PEX),...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9968919/ https://www.ncbi.nlm.nih.gov/pubmed/36861080 http://dx.doi.org/10.3389/fped.2023.979619 |
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author | Ocak, Ilhan |
author_facet | Ocak, Ilhan |
author_sort | Ocak, Ilhan |
collection | PubMed |
description | PURPOSE: Acute liver failure (ALF) is a life-threatening disease characterized by rapid-onset liver dysfunction, coagulopathy, and encephalopathy in patients without chronic liver disease. Today, the combined application of continuous veno-venous hemodiafiltration (CVVHDF) and plasma exchange (PEX), which are forms of supportive extracorporeal therapy (SECT), with conventional liver therapy in ALF is recommended. This study aims to retrospectively analyze the effects of combined SECT in pediatric patients with ALF. MATERIALS AND METHODS: We retrospectively analyzed 42 pediatric patients, followed in the liver transplantation intensive care unit. The patients had ALF and received PEX supportive therapy with combined CVVHDF. The biochemical lab values of the results for the patients before the first combined SECT and after the last combined SECT were analyzed comparatively. RESULTS: Of the pediatric patients included in our study, 20 were girls and 22 were boys. Liver transplantation was performed in 22 patients, and 20 patients recovered without transplantation. After the discontinuation of combined SECT, all patients had significantly lower serum liver function test results (total bilirubin, alanine transaminase, aspartate transaminase), ammonia, and prothrombin time/international normalized ratio levels than the previous levels (p < 0.01). Hemodynamic parameters (i.e., mean arterial pressure) also improved significantly. DISCUSSION AND CONCLUSION: Combined CVVHDF and PEX treatment significantly improved biochemical parameters and clinical findings, including encephalopathy, in pediatric patients with ALF. PEX therapy combined with CVVHDF is a proper supportive therapy for bridging or recovery. |
format | Online Article Text |
id | pubmed-9968919 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-99689192023-02-28 Value of extracorporeal artificial liver support in pediatric acute liver failure: A single-center experience of over 10 years Ocak, Ilhan Front Pediatr Pediatrics PURPOSE: Acute liver failure (ALF) is a life-threatening disease characterized by rapid-onset liver dysfunction, coagulopathy, and encephalopathy in patients without chronic liver disease. Today, the combined application of continuous veno-venous hemodiafiltration (CVVHDF) and plasma exchange (PEX), which are forms of supportive extracorporeal therapy (SECT), with conventional liver therapy in ALF is recommended. This study aims to retrospectively analyze the effects of combined SECT in pediatric patients with ALF. MATERIALS AND METHODS: We retrospectively analyzed 42 pediatric patients, followed in the liver transplantation intensive care unit. The patients had ALF and received PEX supportive therapy with combined CVVHDF. The biochemical lab values of the results for the patients before the first combined SECT and after the last combined SECT were analyzed comparatively. RESULTS: Of the pediatric patients included in our study, 20 were girls and 22 were boys. Liver transplantation was performed in 22 patients, and 20 patients recovered without transplantation. After the discontinuation of combined SECT, all patients had significantly lower serum liver function test results (total bilirubin, alanine transaminase, aspartate transaminase), ammonia, and prothrombin time/international normalized ratio levels than the previous levels (p < 0.01). Hemodynamic parameters (i.e., mean arterial pressure) also improved significantly. DISCUSSION AND CONCLUSION: Combined CVVHDF and PEX treatment significantly improved biochemical parameters and clinical findings, including encephalopathy, in pediatric patients with ALF. PEX therapy combined with CVVHDF is a proper supportive therapy for bridging or recovery. Frontiers Media S.A. 2023-02-13 /pmc/articles/PMC9968919/ /pubmed/36861080 http://dx.doi.org/10.3389/fped.2023.979619 Text en © 2023 Ocak. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Ocak, Ilhan Value of extracorporeal artificial liver support in pediatric acute liver failure: A single-center experience of over 10 years |
title | Value of extracorporeal artificial liver support in pediatric acute liver failure: A single-center experience of over 10 years |
title_full | Value of extracorporeal artificial liver support in pediatric acute liver failure: A single-center experience of over 10 years |
title_fullStr | Value of extracorporeal artificial liver support in pediatric acute liver failure: A single-center experience of over 10 years |
title_full_unstemmed | Value of extracorporeal artificial liver support in pediatric acute liver failure: A single-center experience of over 10 years |
title_short | Value of extracorporeal artificial liver support in pediatric acute liver failure: A single-center experience of over 10 years |
title_sort | value of extracorporeal artificial liver support in pediatric acute liver failure: a single-center experience of over 10 years |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9968919/ https://www.ncbi.nlm.nih.gov/pubmed/36861080 http://dx.doi.org/10.3389/fped.2023.979619 |
work_keys_str_mv | AT ocakilhan valueofextracorporealartificialliversupportinpediatricacuteliverfailureasinglecenterexperienceofover10years |