严重疾病中的肝支持疗法 - - 对程序特征和安全性的比较分析
Daniel Göth1, Christoph F Mahler1, Florian Kälble1
1Department of Nephrology, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Journal of clinical medicine
|July 29, 2023
概括
身体外肝支持疗法,如MARS,TPE和CytoSorb,表现出不同的有效性. 根据患者的需要和目标分子清除,选择合适的治疗方法对于改善急性肝功能障碍的结果至关重要.
科学领域:
- 临界护理医学 临界护理医学
- 肝病学 肝病学是一种肝病学.
- 脏替代疗法治疗 脏替代疗法
背景情况:
- 外体肝支持疗法 (ELT) 是有争议的,因为在重症患者不一致的结果.
- 之前的研究可能受到异质标准,治疗不足和缺乏模式选择的限制.
研究的目的:
- 追溯调查三个ELT的程序特征和安全性:CytoSorb,MARS和TPE.
- 为了比较这些疗法在清除不同分子物质方面的疗效.
主要方法:
- 对CytoSorb,MARS和TPE的程序数据进行了回顾性分析.
- 评估清除特征,包括度依赖性和分子量影响.
- 对安全性和并发症率的评估.
主要成果:
- TPE在更短的持续时间,清除较大的分子,保存血小板和改善血液动力学方面表现出色.
- CytoSorb和MARS证明了对小的,与蛋白质结合的,水溶性的物质的优越减少.
- 清除对所有疗法都是度依赖的,对于CytoSorb和MARS,清除是分子重量依赖的. 没有报告严重并发症.
结论:
- 描述疾病驱动分子是优化ELT在急性肝功能障碍中的使用的关键.
- TPE适合患有出血风险,合成受损和血液动力学不稳定的患者.
- CytoSorb和MARS适用于消除较小的有毒化合物.
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