HIGH-VOLUME PLASMA-EXCHANGE IN FULMINANT HEPATIC-FAILURE
HIGH-VOLUME PLASMA-EXCHANGE IN FULMINANT HEPATIC-FAILURE
复制标题
DOI：
10.1177/039139889201501110
复制
发表时间：
1992-11-01
影响因子：
1.7
通讯作者：
TYGSTRUP, N
中科院分区：
文献类型：
--
作者：
KONDRUP, J;ALMDAL, T;TYGSTRUP, N
我们研究了11例暴发性肝功能衰竭患者使用新鲜供体血浆反复进行大容量血浆置换的效果，这些患者最初均为3期或4期脑病。计划连续三天每日交换等于细胞外体积（体重的20%）的体积。我们获得了平均2.6次交换，每次平均体积等于体重的16%。5名患者（46%，95%置信限17%-77%）存活，均因对乙酰氨基酚引起的肝衰竭。6例死亡者中有4例显示脑功能暂时改善。两个病人完全醒了。6名非幸存者在开始血浆置换后平均6.9天内保持稳定状态，收缩压>110 mm Hg。在最终决定移植前，对肝功能残留的急性肝功能衰竭患者可考虑进行血浆置换。此外，血浆置换可用于使明确的肝功能衰竭患者在临床上保持稳定，直到可以进行移植。
We investigated the effect of repeated high volume plasma exchange with fresh donor plasma in 11 patients with fulminant hepatic failure, all initially in stage 3 or 4 encephalopathy. A daily exchange of a volume equal to the extracellular volume (20% of body weight) on three consecutive days was intended. We obtained an average of 2.6 exchanges each with a mean volume equal to 16% of the body weight. Five patients (46%, 95% confidence limits 17%-77%) survived, all with acetaminophen induced liver failure. Four of the 6 non-survivors showed a temporary improvement in cerebral function. Two of the patients woke up completely. The 6 non-survivors maintained a stable condition with a systolic blood pressure >110 mm Hg for a mean of 6.9 days after initiating plasma exchange. Plasma exchange may be considered in acute liver failure in patients with residual liver function before transplantation is finally decided. In addition, plasmapheresis may be used to keep patients with definite liver failure clinically stable until a transplant can be performed.