Liver support in fulminant liver failure after hemorrhagic shock

  title={Liver support in fulminant liver failure after hemorrhagic shock},
  author={Peter Faybik and Hubert Hetz and Claus Krenn and Amir Baker and Peter Germann and Gabriela Berlakovich and Rudolf Steininger and Heinz Steltzer},
  journal={Wiener Klinische Wochenschrift},
ZusammenfassungFulminantes Leberversagen stellt eine interdis ziplinäre medizinische Herausforderung dar. Trotz den Verbesserungen in der Intensivmedizin bleibt die Mortalität mit bis zu 80% aufgrund der Komplikationen wie Hirnödem, Sepsis und Multiorganversagen hoch. Die einzige kurative Therapie für Patienten mit fulminantem Leberversagen, bei denen eine spontane Regeneration nicht möglich ist, stellt die Lebertransplantation dar. Dies ist aber mangels Spenderorganen und der kritischen… 
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Therapeutic approaches to shock liver focus on the prevention of precipitating causes and Prompt resuscitation, meticulous supportive care, controlling of circulation parameters and metabolism, in addition to the cautious monitoring of therapeutic measures reduce the incidence and severity of liver dysfunction.
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With regional citrate antICOagulation for multipass albumin dialysis and filtering, the need for systemic anticoagulation – a potentially very harmful measure in these patients – can be eliminated and the rate of filter clotting can extremely effectively be reduced.
replacement The Molecular Adsorbent Recirculating System (MARS) clears the blood from catabolites that either occur free in the plasma water (through dialysis), such as uremic toxins and ammonia, or
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Cerebral cortical microcirculatory flow was fully preserved during cardiogenic shock, further document a dissociation between the systemic and cerebral circulations and potentially explain earlier clinical and experimental observations that the brain is selectively protected during severe states of cardiogenesis shock in the absence of cardiac arrest.
The cerebral microcirculation is protected during experimental hemorrhagic shock*
In contrast to the systemic decreases in pressure and flow characteristics of hemorrhagic shock, including decreases in microcirculations of buccal mucosa, cerebral microvascular flow was preserved during moderate and severe blood losses.
Liver support in acute liver failure
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  • Medicine
    Wiener Klinische Wochenschrift
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