《Table 3 Studies included in for study of plasmapheresis in acute liver failure in pediatric cohort》

《Table 3 Studies included in for study of plasmapheresis in acute liver failure in pediatric cohort》   提示:宽带有限、当前游客访问压缩模式
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《Plasma exchange in patients with acute and acute-on-chronic liver failure: A systematic review》


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There is currently no clear evidence to support the use of other assist devices in addition to plasma exchange in management of ALF.Several studies[4,10,20]included alternative assist devices to plasma exchange and made comparisons of its efficacy in the treatment of acute liver failure.For example,comparing plasma exchange vs plasma exchange+continuous venovenous hemodiafiltration(CVVHDF),Nakae et al[10]showed that the latter resulted in a decrease in inflammatory mediators and an increase in citrate compared to the former group.Another study,also by Nakae et al[10],reported use of plasmadiafiltration,a blood purification therapy where plasma exchange is performed using a selective membrane plasma separator while the dialysate flows outside the hollow fibers for management of ALF.In that study[21],less Table 2 Studies included for study of plasmapheresis in acute liver failure in adultsplasma was used per cycle:1200 mL fresh frozen plasma(FFP)and 50 mL of 25%albumin per session.However,patients had an average of 8.3 cycles of plasmadiafiltration,which is higher compared to other studies(Table 2).Transplant free survival rate was 38.1%,54.5%in ALF,and 20%in fulminant hepatitis;there was no control arm.Pediatric studies were evaluated separately,and in the included pediatric studies[19,22-27],the amount of plasma exchange per session ranged from 1-4plasma volumes per exchange.