tailieunhanh - Báo cáo khoa học: "A The Molecular Adsorbent Recirculating System (MARS®) in the intensive care unit: a rescue therapy for patients with hepatic failure"

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: A The Molecular Adsorbent Recirculating System (MARS®) in the intensive care unit: a rescue therapy for patients with hepatic failure. | Available online http content 10 1 118 Commentary The Molecular Adsorbent Recirculating System MARS in the intensive care unit a rescue therapy for patients with hepatic failure Faouzi Saliba AP-HP Hôpital Paul Brousse Service d hépato-gastroentérologie Villejuif 94804 France Corresponding author Faouzi Saliba Published 8 February 2006 This article is online at http content 10 1 118 2006 BioMed Central Ltd Critical Care 2006 10 118 doi cc4825 Abstract Treatment in the intensive care unit of patients with end-stage liver disease has been limited. Liver transplantation has been a major improvement in this and has become standard in the management of these patients. However many patients die awaiting liver transplantation mainly due to the scarcity of organ donors. Conventional hemodialysis techniques have little or no effect on liver detoxification and do not improve the prognosis of these patients. In patients with acute hepatic failure the majority of endogenous toxins leading to organ failure and accumulating in the blood are bound to albumin therefore the concept of albumin dialysis is of major interest. To date the most widely developed system has been the Molecular Adsorbent Recirculating System MARS which is based on the selective removal of albuminbound toxins from the blood. MARS enables simultaneous liver and kidney detoxification improving the patient s clinical condition. It is a major improvement in the management of patients with hepatic failure that could permit when appropriately indicated recovery from an acute episode and enhance the chances of survival while waiting for an available organ donor. Introduction During the past decades few therapeutic measures have been developed for the treatment of patients with end-stage liver disease. Despite a great improvement in the field of transplantation the mortality in patients developing hepatic failure remains very high and many patients die while