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2024, Number 4

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Med Crit 2024; 38 (4)

Mortality with use of high-volume plasmapheresis versus conventional management in patients with acute liver failure in the Intensive Care Unit

Castrejón-Sánchez JE, Gasca-Aldama JC, Alva-Arroyo NV, Amezcua-Gutiérrez MA, López-Rodríguez KH, Vidals-Sánchez M

Language: Spanish
References: 32
Page: 284-288
PDF size: 253.89 Kb.


ABSTRACT

Acute liver failure is a rare pathology, however, when it occurs requires multidisciplinary management and admission to the intensive care unit. The reported incidence reaches no more than 2,000 cases per year in the United States, in Mexico the exact figure is unknown. The most common causes are paracetamol overdose and hepatotropic virus infection. In recent years, with the advent of new technologies and new evidence, extracorporeal support treatment strategies have been implemented for these patients, such as high-volume plasmapheresis, which has been compared against conventional therapy, reporting results with reduced in mortality, less day in the intensive care unit and better results in transplant patients. In our cohort, the survivor group used extracorporeal support in a higher percentage with 38.4%, in contrast to the group with higher mortality in whom it was only used in 14.3% (p = 0.018). Deducing that patients with higher mortality did not receive plasmapheresis and also death occurred early between days 1 to 3 (p = 0.006). This difference presented statistical significance in the bivariate analysis. To date, it is the only study in an intensive care unit in Mexico that evaluated mortality in this group of patients using high volume plasma exchange as a extracorporeal therapy versus standard treatment.


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