分子吸附剂循环再循环系统 (MARS®) 和用于治疗儿科急性肝衰竭的连续置换疗法 - 两中心回顾性队列研究
Romit Saxena1, Emma C Alexander1,2, Sander Bontemps3
1Paediatric Intensive Care, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK.
European journal of pediatrics
|February 12, 2025
概括
持续置换疗法 (CRRT) 和分子吸附剂循环系统 (MARS®) 在患有儿科急性肝衰竭 (PALF) 的儿童中显示出类似的结果. 需要进一步的研究来确定PALF患者的最佳体外治疗方法.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 肝病学 肝病学是一种肝病学.
- 腎臟病學 (nephrology) 是一種醫學.
背景情况:
- 儿科急性肝衰竭 (PALF) 管理得到了改善,减少了对肝移植的需求.
- 外体疗法 (ECT),如连续置换疗法 (CRRT),在PALF中越来越多地使用,但不同ECT之间的比较是有限的.
研究的目的:
- 为了比较患有PALF的儿科患者的临床结果,他们接受了CRRT或MARS®治疗.
主要方法:
- 在两个欧洲儿科重症监护病房 (PICU) 进行了一项回顾性观察队列研究.
- 分析了95名PALF患者的数据 (23人接受MARS®治疗,72人接受CRRT治疗),年龄在0-18岁之间.
- 在MARS®和CRRT组之间比较了基线特征,生化参数和临床结果,包括与原生肝脏的存活率和整体存活率.
主要成果:
- 与CRRT组相比,MARS®组的患者比例较低,接受异构或通风治疗,儿童死亡率指数3风险得分较低.
- 尽管CRRT组中患病率较高,但在MARS®和CRRT组之间没有发现与本地肝脏的存活率或整体存活率的显著差异 (MARS®为65.2%,CRRT为68.1%).
结论:
- 在接受CRRT或MARS®治疗的PALF患者之间没有观察到临床结果的显著差异.
- 需要进一步进行高质量的研究,以确定不同体外治疗在PALF中的作用,考虑结果,可行性和成本.
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