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首页> 外文期刊>Artificial Organs >Prometheus versus molecular adsorbents recirculating system: comparison of efficiency in two different liver detoxification devices.
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Prometheus versus molecular adsorbents recirculating system: comparison of efficiency in two different liver detoxification devices.

机译：普罗米修斯与分子吸附剂再循环系统：比较两种不同的肝脏排毒设备的效率。

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Albumin dialysis by the molecular adsorbents recirculating system (MARS) and by fractionated plasma separation, adsorption, and dialysis (Prometheus[PROM]) represent novel nonbiological liver support systems specifically designed to remove albumin-bound substances. Preliminary evidence suggests a favorable impact of MARS on the course and outcome of liver failure. This study aimed at comparing the detoxification capacity of both devices. For this purpose, we performed a retrospective analysis on data prospectively collected in patients with acute-on-chronic liver failure treated with either the MARS (n = 9) or the PROM (n = 9) device on 2-5 consecutive days. Each treatment was performed for at least 5 h at identical blood and dialysate flows. Blood clearances were calculated during the first treatment session for urea nitrogen, creatinine, total bilirubin, and bile acids from paired arterial and venous line samples after 1, 4, and 6 h of treatment. Reduction ratios for all single-treatment sessions, and the overall treatment phase, were calculated from pretreatment and post-treatment values. For all markers but bile acids, the single-treatment as well as the overall treatment phase reduction ratios obtained with PROM were significantly higher compared with those obtained with MARS. PROM led at all time points to higher clearances for all evaluated solutes. Blood clearances of protein-bound substances declined over time with MARS, but not with PROM. In conclusion, a significant decline in the serum level of water-soluble and protein-bound toxins was achieved with both devices. PROM produces higher blood clearances for most toxins, which results in higher delivered treatment doses compared with a matching treatment with MARS.
机译：通过分子吸附剂再循环系统（MARS）以及通过分级血浆分离，吸附和透析（Prometheus [PROM]）进行的白蛋白透析代表了专门设计用于去除与白蛋白结合的物质的新型非生物肝脏支持系统。初步证据表明，MARS对肝衰竭的病程和结局具有有利影响。这项研究旨在比较两种设备的排毒能力。为此，我们对连续2-5天接受MARS（n = 9）或PROM（n = 9）装置治疗的慢性慢性肝功能衰竭患者的预期数据进行了回顾性分析。每种治疗均在相同的血液和透析液流量下进行至少5小时。在治疗的第1、4和6小时后，从配对的动脉和静脉管线样本中计算尿素氮，肌酐，总胆红素和胆汁酸的血液清除率。从治疗前和治疗后的值计算所有单次治疗疗程和整个治疗阶段的减少率。对于除胆汁酸以外的所有标记物，与使用MARS获得的标记物相比，使用PROM获得的单次处理以及总处理阶段减少率均明显更高。在所有时间点上，PROM导致所有评估溶质的清除率更高。随着时间的流逝，蛋白结合物质的血液清除率随MARS而下降，但随PROM下降。总之，使用这两种设备均可使血清中水溶性和蛋白结合毒素的血清水平显着下降。 PROM产生的大多数毒素的血液清除率更高，与MARS的匹配治疗相比，这导致更高的给药剂量。

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