An evaluation of the usefulness of extracorporeal liver support techniques in patients with severe liver dysfunction

Introduction The mortality rate in patients with severe liver dysfunction with no option of transplantation is unacceptably high. The main aim of this study was to evaluate the usefulness of applying extracorporeal liver support (ECLS) techniques in this group of patients. Material and methods Data...

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Autores principales:	Mariusz Piechota, Anna Piechota, Małgorzata Misztal, Szymon Bernas, Iwona Pietraszek-Grzywaczewska
Formato:	article
Lenguaje:	EN
Publicado:	Termedia Publishing House 2018
Materias:	fractionated plasma separation and adsorption single pass albumin dialysis sequential organ failure assessment acute physiology and chronic health evaluation ii simplified acute physiology score ii model of end-stage liver disease unos modification Medicine R
Acceso en línea:	https://doaj.org/article/05db9852157741449067b71feb0b5828
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spelling	oai:doaj.org-article:05db9852157741449067b71feb0b58282021-12-02T19:15:49ZAn evaluation of the usefulness of extracorporeal liver support techniques in patients with severe liver dysfunction1734-19221896-915110.5114/aoms.2017.67998https://doaj.org/article/05db9852157741449067b71feb0b58282018-12-01T00:00:00Zhttps://www.archivesofmedicalscience.com/An-evaluation-of-the-usefulness-of-extracorporeal-liver-support-techniques-in-patients,68224,0,2.htmlhttps://doaj.org/toc/1734-1922https://doaj.org/toc/1896-9151Introduction The mortality rate in patients with severe liver dysfunction with no option of transplantation is unacceptably high. The main aim of this study was to evaluate the usefulness of applying extracorporeal liver support (ECLS) techniques in this group of patients. Material and methods Data from hospital admissions of 101 patients with severe liver dysfunction who were admitted to the department of Anaesthesiology and intensive therapy between 2006 and 2015 were retrospectively analysed. The study group was divided into two subgroups. Standard Medical therapy (SMT) was a subgroup of patients receiving standard Medical therapy, and SMT + ECLS was a subgroup containing patients receiving standard medical therapy complemented by at least one extracorporeal liver support procedure. Results Significantly lower intensive care unit (ICU) mortality and 30-day mortality rates were found in the SMT + ECLS subgroup (p = 0.0138 and p = 0.0238 respectively). No difference in 3-month mortality was identified between the two groups. In a multivariate model, independent risk factors for ICU mortality proved to be the SOFA score and prothrombin time. The highest discriminatory power for ICU mortality was demonstrated for the SOFA score, followed by APACHE II, SAPS II, MELD UNOS and GCS scores. For 30-day mortality, however, the best discriminatory power was shown for the SAPS II score, followed by SOFA, APACHE II, MELD UNOS and GCS scores. Conclusions Further studies are needed to assess the contribution of non-biological extracorporeal liver support procedures to a decrease in mortality rates in the population of patients with severe liver dysfunction.Mariusz PiechotaAnna PiechotaMałgorzata MisztalSzymon BernasIwona Pietraszek-GrzywaczewskaTermedia Publishing Housearticlefractionated plasma separation and adsorptionsingle pass albumin dialysissequential organ failure assessmentacute physiology and chronic health evaluation iisimplified acute physiology score iimodel of end-stage liver disease unos modificationfractionated plasma separation and adsorptionsingle pass albumin dialysissequential organ failure assessmentMedicineRENArchives of Medical Science, Vol 15, Iss 1, Pp 99-112 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	fractionated plasma separation and adsorption single pass albumin dialysis sequential organ failure assessment acute physiology and chronic health evaluation ii simplified acute physiology score ii model of end-stage liver disease unos modification fractionated plasma separation and adsorption single pass albumin dialysis sequential organ failure assessment Medicine R
spellingShingle	fractionated plasma separation and adsorption single pass albumin dialysis sequential organ failure assessment acute physiology and chronic health evaluation ii simplified acute physiology score ii model of end-stage liver disease unos modification fractionated plasma separation and adsorption single pass albumin dialysis sequential organ failure assessment Medicine R Mariusz Piechota Anna Piechota Małgorzata Misztal Szymon Bernas Iwona Pietraszek-Grzywaczewska An evaluation of the usefulness of extracorporeal liver support techniques in patients with severe liver dysfunction
description	Introduction The mortality rate in patients with severe liver dysfunction with no option of transplantation is unacceptably high. The main aim of this study was to evaluate the usefulness of applying extracorporeal liver support (ECLS) techniques in this group of patients. Material and methods Data from hospital admissions of 101 patients with severe liver dysfunction who were admitted to the department of Anaesthesiology and intensive therapy between 2006 and 2015 were retrospectively analysed. The study group was divided into two subgroups. Standard Medical therapy (SMT) was a subgroup of patients receiving standard Medical therapy, and SMT + ECLS was a subgroup containing patients receiving standard medical therapy complemented by at least one extracorporeal liver support procedure. Results Significantly lower intensive care unit (ICU) mortality and 30-day mortality rates were found in the SMT + ECLS subgroup (p = 0.0138 and p = 0.0238 respectively). No difference in 3-month mortality was identified between the two groups. In a multivariate model, independent risk factors for ICU mortality proved to be the SOFA score and prothrombin time. The highest discriminatory power for ICU mortality was demonstrated for the SOFA score, followed by APACHE II, SAPS II, MELD UNOS and GCS scores. For 30-day mortality, however, the best discriminatory power was shown for the SAPS II score, followed by SOFA, APACHE II, MELD UNOS and GCS scores. Conclusions Further studies are needed to assess the contribution of non-biological extracorporeal liver support procedures to a decrease in mortality rates in the population of patients with severe liver dysfunction.
format	article
author	Mariusz Piechota Anna Piechota Małgorzata Misztal Szymon Bernas Iwona Pietraszek-Grzywaczewska
author_facet	Mariusz Piechota Anna Piechota Małgorzata Misztal Szymon Bernas Iwona Pietraszek-Grzywaczewska
author_sort	Mariusz Piechota
title	An evaluation of the usefulness of extracorporeal liver support techniques in patients with severe liver dysfunction
title_short	An evaluation of the usefulness of extracorporeal liver support techniques in patients with severe liver dysfunction
title_full	An evaluation of the usefulness of extracorporeal liver support techniques in patients with severe liver dysfunction
title_fullStr	An evaluation of the usefulness of extracorporeal liver support techniques in patients with severe liver dysfunction
title_full_unstemmed	An evaluation of the usefulness of extracorporeal liver support techniques in patients with severe liver dysfunction
title_sort	evaluation of the usefulness of extracorporeal liver support techniques in patients with severe liver dysfunction
publisher	Termedia Publishing House
publishDate	2018
url	https://doaj.org/article/05db9852157741449067b71feb0b5828
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An evaluation of the usefulness of extracorporeal liver support techniques in patients with severe liver dysfunction

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