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首页> 外文期刊>Pediatric critical care medicine: a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies >Hybrid Extracorporeal Therapies as a Bridge to Pediatric Liver Transplantation
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Hybrid Extracorporeal Therapies as a Bridge to Pediatric Liver Transplantation

机译：混合体外疗法作为儿科肝移植的桥梁

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Objectives: Standard intensive care treatment is inadequate to keep children with liver failure alive without catastrophic complications to ensure successful transplant, as accumulation of endogenous protein-bound toxins often lead to hepatic encephalopathy, hepatorenal syndrome, cardiovascular instability, and multiple organ failure. Given paucity of proven treatment modalities for liver failure, blood purification using different extracorporeal treatments as a bridge to transplantation is used, but studies evaluating the safety and efficacy of combination of these therapies, especially in pediatric liver failure, are lacking. We describe our experience at a major tertiary children's hospital, where a unique hybrid extracorporeal treatment protocol has been instituted and followed for acute liver failure or acute-on-chronic liver failure as a bridge to transplantation. This protocol combines high-flux continuous renal replacement therapy for hyperammonemia, therapeutic plasma exchange for coagulopathy, and albumin-assisted dialysis (molecular adsorbent recirculating system) for hepatic encephalopathy.
机译：目的：标准密集护理治疗不充分，以保持肝脏失效的肝脏失效，没有灾难性的并发症，以确保内源性蛋白质结合的毒素的积累经常导致肝脑病，肝癌综合征，心血管不稳定性和多器官衰竭。鉴于缺乏肝脏衰竭的治疗方式的缺乏，使用使用不同体外处理作为移植桥的血液净化，但研究了这些疗法组合的安全性和功效，特别是在儿科肝功能衰竭中。我们描述了我们在主要的第三节儿童医院的经验，其中制定了独特的混合体体外治疗方案，并随访急性肝功能衰竭或急性慢性肝脏衰竭作为移植的桥梁。该方案结合了高通量连续肾置换疗法对肝脏病变治疗血浆交换的高通量连续肾脏替代疗法，治疗凝血病，肝脏辅助透析（分子吸附循环系统）用于肝脑病。

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