APPLICATION OF HEMOCARBOPERFUSION AND EXTRACORPOREAL LIVER SUPPORT IN PATIENTS WITH LIVER FAILURE DURING THE EXTRACORPOREAL BLOOD PURIFICATION
Abstract
Background. In recent years scientists have actively used extracorporeal blood purification in different categories of patients. However, the way these methods influence homeostasis has been studied insufficiently. The technique of the extracorporeal liver support, selectively removing albumin-bound toxins, is now used in large ICU rather actively. At the same time, the number of centres uses haemocarboperfusion as an alternative to extracorporeal support in hepatic failure.
Materials and methods. The effect of extracorporeal liver support with "Prometheus" and haemocarboperfusion through the "Simplex-F" sorbent on the transport properties of albumin in 29 patients with hepatic insufficiency has been analyzed in a prospective, randomized trial. All the patients were divided in two groups. Group I (19 patients) underwent 3 extracorporeal liver support procedures with «Prometheus» technology (Fresenius, Germany). In Group II 10 patients got haemocarboperfusion through the "Simplex-F" sorbent. The number of sessions ranged from 3 to 7.
Results. As a result, it has been stated that the use of haemocarboperfusion through the sorbent "Simplex-F" does not cause any significant impact on the albumin transport ability (40,7%) in patients with hepatic insufficiency.
Conclusion. The use of «Prometheus» technology enables to restore the lost albumin transport function from 31,5% to 83,2%, to remove albumin-bound and water-soluble toxins to stabilize haemodynamics, reduce the symptoms of cytolytic and cholestatic syndromes.
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