Document Detail


Modular extracorporeal life support for multiorgan failure patients.
MedLine Citation:
PMID:  12220309     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Adults receiving respiratory Extracorporeal Membrane Oxygenation (ECMO) have 66% survival. Nonsurvivors develop multisystem organ failure (MSOF). Once hepatic failure develops, death usually follows shortly. Serum bilirubin > 300 micromol/l predicted death with 87.8% sensitivity and 90.3% specificity in 41 adults who received ECMO in our institution during 1998 and 1999. No patients survive with a peak bilirubin > 400 micromol/l. The Molecular Adsorbent Recirculating System (MARS) is a cell-free extracorporeal liver support device; we hypothesized that using MARS in adult respiratory ECMO patients with a bilirubin >300 micromol/l could improve survival in MSOF. The MARS was used in five such patients aged 19-56 who developed liver failure secondary to a respiratory illness. Mean peak bilirubin was 529 micromol/l and the lowest peak bilirubin was 436 micromol/l. Patients received between 1 and 8 MARS treatments, mean reduction in serum bilirubin for each patient ranging between 30 and 162 micromol/l. Two of five patients survived (40%), survivors showing the greatest reduction in serum bilirubin in response to MARS. All patients would have been expected to die according to our previous experience. We believe that MARS may prove a useful therapy for patients with MSOF.
Authors:
Giles J Peek; Hillary M Killer; Marcin A Sosnowski; Richard K Firmin
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Liver     Volume:  22 Suppl 2     ISSN:  0106-9543     ISO Abbreviation:  Liver     Publication Date:  2002  
Date Detail:
Created Date:  2002-09-10     Completed Date:  2003-04-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8200939     Medline TA:  Liver     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  69-71     Citation Subset:  IM    
Affiliation:
Division of Cardiac Surgery, University of Leicester, Glenfield Hospital, UK. ycq57@dial.pipex.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Extracorporeal Membrane Oxygenation*
Humans
Liver Failure / therapy
Middle Aged
Multiple Organ Failure / mortality,  therapy*
Prospective Studies
Renal Dialysis*
Retrospective Studies
Sorption Detoxification*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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