Hepatic encephalopathy and cerebral blood flow improved by liver dialysis treatment
Journal
International Journal of Artificial Organs
Journal Volume
26
Journal Issue
2
Pages
149-151
Date Issued
2003
Author(s)
Abstract
Eight acute liver failure patients, all in grade IV hepatic encephalopathy, were administered liver dialysis treatment with the Hemo Therapies Unit (Hemo Therapies Inc, San Diego, CA, USA). The patients were evaluated to determine whether the Glasgow Coma Scale score and cerebral blood flow improved with treatment. After the initial treatment, consciousness levels as measured by the Glasgow Coma Scale improved from a pre-treatment median of 5 (range 3 to 6) to a post-treatment median of 7 (range 5 to 9) (p=0.0005 by paired Wilcoxon test); mean blood flow velocity in the middle cerebral arteries as shown by transcranial Doppler sonography increased from a median of 37.85 cm/sec (range 20.3 to 114.0) to 57.90 (32.5 to 135.0) post-treatment (p=0.022); however, there was no significant change in the pulsatility index from a median of 1.18 (range 0.61 to 1.71) to 0.85 (range 0.70 ? 1.79) post-treatment (p=0.13). The 8 patients received 2 to 7 (median 5.5) times of daily 6-h liver dialysis treatments. Following the completion of all liver dialysis treatments, hepatic coma was fully resolved in 4 of 8 patients (50%). Three of 8 patients (37.5%) survived to hospital discharge, whereas 5 patients did not survive due to irreversible liver function and associated complications. In conclusion, liver dialysis treatment could improve hepatic encephalopathy, but the prognosis still depended on the underlying diseases.
Subjects
Acute liver failure; Cerebral blood flow; Glasgow Coma Scale; Hemo therapies unit; Hepatic encephalopathy; Liver dialysis; Transcranial Doppler sonography
SDGs
Other Subjects
Blood; Blood vessels; Diagnosis; Flow velocity; Hemodynamics; Patient treatment; Ultrasonography; Acute liver failure; Cerebral blood flow; Glasgow coma scale; Hemo therapy unit; Hepatic encephalopathies; Initial treatment; Liver dialysis; Post treatment; San Diego; Transcranial doppler sonography; Dialysis; adult; aged; article; blood flow velocity; brain blood flow; clinical article; clinical trial; consciousness; controlled clinical trial; controlled study; dialysis; Doppler echography; female; Glasgow coma scale; hepatic coma; hepatic encephalopathy; hospital discharge; human; liver failure; male; middle cerebral artery; outcomes research; prognosis; prospective study; pulsatile flow; survival; treatment outcome; Wilcoxon signed ranks test; artificial liver; brain circulation; dialysis; echography; evaluation; liver; methodology; middle aged; pathophysiology; physiology; Adult; Aged; Blood Flow Velocity; Cerebrovascular Circulation; Dialysis; Female; Glasgow Coma Scale; Hepatic Encephalopathy; Humans; Liver; Liver Failure, Acute; Liver, Artificial; Male; Middle Aged; Middle Cerebral Artery; Prospective Studies; Pulsatile Flow; Ultrasonography, Doppler, Transcranial
Type
journal article