tailieunhanh - Báo cáo khoa học: " Equipment review: The molecular adsorbents recirculating system (MARS®)"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Equipment review: The molecular adsorbents recirculating system (MARS®). | Critical Care August 2004 Vol 8 No 4 Boyle et al. Review Equipment review The molecular adsorbents recirculating system MARS Martin Boyle1 Jelica Kurtovic2 David Bihari3 Stephen Riordan4 and Christian Steiner5 1 Clinical Nurse Consultant - Intensive Care Department of Intensive Care The Prince of Wales Hospital Randwick NSW Australia 2Fellow in Hepatology Gastrointestinal and Liver Unit The Prince of Wales Hospital Randwick NSW Australia 3Associate Professor Senior Staff Specialist Department of Intensive Care The Prince of Wales Hospital Randwick NSW Australia 4Associate Professor of Medicine and Director Gastrointestinal and Liver Unit The Prince of Wales Hospital Randwick NSW Australia 5Marketing Director Teraklin AG Hamburg Germany and Visiting Research Fellow Institute of Hepatology UCL London UK Corresponding author Stephen Riordan riordans@ Published online 24 June 2004 This article is online at http content 8 4 280 2004 BioMed Central Ltd Critical Care 2004 8 280-286 DOI cc2895 Abstract The molecular adsorbents recirculating system MARS is a form of artificial liver support that has the potential to remove substantial quantities of albumin-bound toxins that have been postulated to contribute to the pathogenesis of liver cell damage haemodynamic instability and multi-organ failure in patients with acute liver failure ALF and acute-on-chronic liver failure AoCLF . These toxins include fatty acids bile acids tryptophan bilirubin aromatic amino acids and nitric oxide. Data from controlled clinical trials are limited so far. One of two studies performed on small numbers of patients with AoCLF suggest a survival benefit but no controlled data are available in the ALF setting. Our preliminary experience with MARS therapy instituted late in the clinical course of five patients with severely impaired liver function including three with AoCLF precipitated by sepsis and two with liver dysfunction due to sepsis in the absence of .