急性和急性至慢性肝衰竭的血交换:系统性审查和元分析
Azizullah Beran1, Mouhand F H Mohamed2, Mohammad Shaear3
1Division of Gastroenterology and Hepatology, Indiana University, Indianapolis, Indiana, USA.
概括
血交换 (PE) 改善了急性肝衰竭 (ALF) 和急性至慢性肝衰竭 (ACLF) 患者的生存率. 这项分析表明,PE对于这些严重的肝脏疾病是一种有益的治疗方法.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 临界护理医学 临界护理医学
- 移植 移植 移植 移植
背景情况:
- 急性肝衰竭 (ALF) 和急性至慢性肝衰竭 (ACLF) 是具有显著死亡率的危急疾病.
- 血交换 (PE) 是一种潜在的治疗干预,但其对生存的影响仍在争论中.
- 标准医学疗法 (SMT) 作为评估这些肝脏综合征的新疗法的比较标准.
结论:
- 血交换与改善ALF的存活率有关,并可能提高ACLF的存活率.
- 对于管理ALF和ACLF患者,可以考虑PE,作为肝移植的替代方案或作为桥梁.
- 需要进行更多的随机对照试验,以最终确定PE在ACLF中的生存益处.
相关概念视频
Acute Kidney Injury IV: Diagnostic Studies and Prevention
35
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
35
Hepatic Drug Clearance: Effect of Protein Binding
245
Hepatic clearance is influenced by protein binding based on the drug's extraction ratio. Drugs with high extraction ratios are considered flow-limited and remain unaffected by protein binding during hepatic clearance. On the other hand, drugs with low extraction ratios may be impacted by plasma protein binding, although the extent of this influence depends on the fraction of the drug bound.
For low-extraction-ratio drugs that are less than 80% protein-bound, minor changes in protein binding...
For low-extraction-ratio drugs that are less than 80% protein-bound, minor changes in protein binding...
245
Acute Kidney Injury V: Interprofessional Care
25
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
25
Kidney Transplant I: Introduction
29
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
29
Acute Kidney Injury I: Introduction
32
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
32


