tailieunhanh - Báo cáo khoa học: "Extracorporeal liver support: a continuing challenge"

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: Extracorporeal liver support: a continuing challenge. | Available online http content 11 1 106 Commentary Extracorporeal liver support a continuing challenge Ram M Subramanian 1 and John A Kellum2 1 Departments of Pulmonary Critical Care and Gastroenterology Hepatology University of Chicago 5841 South Maryland Ave. MC 6076 ChiCago IL 60637 USA 2Department of Critical Care Medicine 608 Scaife Hall University of Pittsburgh School of Medicine 3550 Terrace Street Pittsburgh PA 15261 USA Corresponding author John A Kellum kellumja@ Published 29 January 2007 This article is online at http content 11 1 106 2007 BioMed Central Ltd Critical Care 2007 11 106 doi cc5143 See related research by Stadlbauer et al. http content 10 6 R169 Abstract Given that liver failure continues to pose an enormous clinical challenge the concept of hepatic dialysis has enjoyed significant interest. In particular many investigations have examined the therapeutic mechanisms and efficacy of artificial albumin dialysis based systems in acute on chronic liver failure the results of which have been conflicting. Albumin dialysis systems do not appear to significantly decrease serum concentrations of inflammatory cytokines in severe acute on chronic liver failure. Thus if these treatments do result in clinical improvement then other therapeutic mechanisms must be involved. In a previous issue of Critical Care Stadlbauer and colleagues 1 examined the effects of two artificial albumin dialysis systems on the removal of cytokines in the setting of acute on chronic liver failure. In the absence of liver transplantation patients with liver failure face limited therapeutic interventions and ultimately suffer multiple organ system dysfunction. The shortage of donor livers and the growing number of patients with advanced liver disease has stimulated active interest in extracorporeal liver support devices including artificial and bio-artificial systems. Although artificial support systems have focused primarily