tailieunhanh - Báo cáo khoa học: "Bench-to-bedside review: Current evidence for extracorporeal albumin dialysis systems in liver 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: Bench-to-bedside review: Current evidence for extracorporeal albumin dialysis systems in liver failure. | Available online http content 11 3 215 Review Bench-to-bedside review Current evidence for extracorporeal albumin dialysis systems in liver failure Constantine J Karvellas1 2 Noel Gibney3 Demetrios Kutsogiannis3 Julia Wendon2 and Vincent G Bain1 1 University of Alberta Liver Unit Zeidler-Ledcor Building 130 University Campus Edmonton Alberta T6G 2X8 Canada institute of Liver Studies King s College Hospital Denmark Hill London SE5 9RS UK 3Division of Critical Care Medicine University of Alberta 3C1 Walter C Mackenzie Health Sciences Centre 8440-112 Street Edmonton Alberta T6G 2B7 Canada Corresponding author Vincent G Bain Published 8 June 2007 This article is online at http content 11 3 215 2007 BioMed Central Ltd Critical Care 2007 11 215 doi cc5922 Abstract Acute liver failure ALF and acute on chronic liver failure AoCLF carry a high mortality. The rationale for extracorporeal systems is to provide an environment facilitating recovery or a window of opportunity for liver transplantation. Recent technologies have used albumin as a scavenging molecule. Two different albumin dialysis systems have been developed using this principle MARS Molecular Adsorbent Recirculation System and SPAD SinglePass Albumin Dialysis . A third system Prometheus Fractionated Plasma Separation and Adsorption differs from the others in that the patient s albumin is separated across a membrane and then is run over adsorptive columns. Although several trials have been published particularly with MARS currently there is a lack of controlled studies with homogenous patient populations. Many studies have combined patients with ALF and AoCLF. Others have included patients with different etiologies. Although MARS and Prometheus have shown biochemical improvements in AoCLF and ALF additional studies are required to show conclusive benefit in short- and long-term survival. The appropriate comparator is standard medical therapy rather than .