Experience with albumin dialysis in five patients with severe overdoses of paracetamol

@article{Koivusalo2003ExperienceWA,
  title={Experience with albumin dialysis in five patients with severe overdoses of paracetamol},
  author={A-M. Koivusalo and Yaşar Yıldırım and Anne Vakkuri and Leena Lindgren and Krister H{\"o}ckerstedt and H Isoniemi},
  journal={Acta Anaesthesiologica Scandinavica},
  year={2003},
  volume={47}
}
Five patients in whom the serum paracetamol levels or the amount of ingested paracetamol was high enough to cause severe liver injury were treated with N‐acetyl‐cysteine (NAC) and a molecular absorbant recirculating system (MARS). MARS treatment was started as early as possible in order to prevent or retard the development of hepatocyte necrosis. Four of our five patients survived without liver transplantation, and one died due to brain oedema. The early commencement with NAC and MARS… 
Sistemas de soporte hepático artificial: estado actual del tratamiento con diálisis de albúmina (MARS)
TLDR
Current clinical experience of albumin dialysis is still limited, although beneficial effects on clinical, laboratory and hemodynamic parameters have been demonstrated, and multi-enter, controlled trials to evaluate the effect of this therapy on survival in distinct diseases are needed.
Molecular adsorbent recirculating system ( MARS ) dialysis for fulminant hepatic failure due to paracetamol overdose in children
TLDR
This case suggests that albumin dialysis may be feasible treatment option in acute liver failure due to paracetamol overdose, and treats a 4-year boy successfully with two sessions of MARS dialysis for fulminant liver failure and grade III hepatic encephalopathy.
Potentially fatal paracetamol overdose and successful treatment with 3 days of intravenous N-acetylcysteine regime--a case report.
TLDR
In very severe paracetamol poisoning, a modified regime of intravenous N- acetylcysteine for 3 days is safe and efficacious, and the patient was discharged without complications on the fifth day.
Severe acetaminophen poisoning treated with a fractionated plasma separation and absorption system: A case report
TLDR
A 17-year-old girl who was admitted to an emergency department 15 hours after taking acetaminophen pills in a suicide attempt had elevated liver enzymes suggesting hepatic necrosis, and was started on N-acetyl cystein (NAC).
Fulminant hepatic failure in woman with iron and non-steroidal anti-inflammatory drug intoxication
TLDR
In the presented case, the ingestion of a very high dose of iron and late introduction of deferoxamine treatment contributed to fulminant liver failure and fatal outcome of the intoxication.
Value of albumin dialysis therapy in severe liver insufficiency
TLDR
MARS is a promising therapy for ALF, allowing the patient's own liver to recover or allowing enough time to find a liver graft, but did not observe much benefit in patients with severe acute‐on‐chronic liver failure (AcoChr) who did not undergo liver transplantation.
Value of albumin dialysis therapy in severe liver insufficiency
TLDR
MARS is a promising therapy for ALF, allowing the patient’s own liver to recover or allowing enough time to find a liver graft, but did not observe much benefit in patients with severe acute-on-chronic liver failure (AcoChr) who did not undergo liver transplantation.
Paracetamol self-poisoning: when oral N-acetylcysteine saves life? a case report
TLDR
It is reported that a 24-year-old Arab female who has deliberately ingested 100 tablets of 500 mg paracetamol each (50g) with the highest par acetamol blood levels ever reported in medical literature was discharged well on the fifth day of hospitalization.
Albumin dialysis has a favorable effect on amino acid profile in hepatic encephalopathy
TLDR
MARS®-albumin dialysis had a favorable effect on the plasma amino acid profile of patients with HE, mainly due to the increase in Fischer’s ratio and the decrease in AAAs.
...
1
2
3
...

References

SHOWING 1-10 OF 30 REFERENCES
Intravenous N-acetylcystine: the treatment of choice for paracetamol poisoning.
TLDR
Intravenous acetylcysteine was more effective than cysteamine and methionine and noticeably free of adverse effects and is the treatment of choice for paracetamol poisoning.
Intravenous N-acetylcysteine: still the treatment of choice for paracetamol poisoning.
TLDR
Intravenous acetylcysteine was more effective than cysteamine and methionine and noticeably free of adverse effects and is the treatment of choice for paracetamol poisoning.
Intravenous acetylcysteine in paracetamol induced fulminant hepatic failure: a prospective controlled trial.
TLDR
Acetylcysteine is safe and effective in fulminant hepatic failure after paracetamol overdose, and rates of deterioration and recovery of liver function were similar in the two groups.
Improvement of hepatorenal syndrome with extracorporeal albumin dialysis mars: Results of a prospective, randomized, controlled clinical trial
  • S. Mitzner, J. Stange, R. Schmidt
  • Medicine
    Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
  • 2000
TLDR
It is concluded that the removal of albumin‐bound substances with the MARS method can contribute to the treatment of type I HRS.
Paracetamol overdose in a liver transplantation centre: An 8‐year experience
  • P. Gow, P. Angus
  • Medicine
    Journal of gastroenterology and hepatology
  • 1999
TLDR
The frequency of attendance at the Austin and Repatriation Medical Centre for paracetamol overdose, the frequency of referral to the Victorian liver transplant unit after serious overdoses, the morbidity and mortality rates in all patients treated and the appropriateness of treatment were assessed.
Clinical use of a bioartificial liver in the treatment of acetaminophen-induced fulminant hepatic failure.
TLDR
The BAL support system seems to improve the outcome of high-risk patients with acetaminophen-induced fulminant hepatic failure, even in the absence of liver transplantation.
Potentiation of acetaminophen hepatotoxicity by alcohol.
TLDR
It is suggested that alcohol enhances acetaminophen hepatotoxicity in mice and provides supportive evidence that these three alcoholic patients probably had a similar pathophysiological basis for their liver disease.
Improvement by acetylcysteine of hemodynamics and oxygen transport in fulminant hepatic failure.
TLDR
The increase in oxygen delivery and consumption in response to acetylcysteine may account for its beneficial effect on survival in patients with fulminant hepatic failure induced by acetaminophen.
Liver support by extracorporeal blood purification: A clinical observation
  • J. Stange, S. Mitzner, U. Hopt
  • Medicine, Biology
    Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
  • 2000
TLDR
It is concluded that in acute excretory failure caused by a chronic liver disease, this treatment provides a therapy option to remove toxins involved in multiorgan dysfunction secondary to liver failure.
...
1
2
3
...