Summary
Two patients with fulminant hepatic necrosis and in stage IV coma were treated with a rapid infusion of refrigerated buffered albumin electrolyte solution combined with simultaneous total body wash-out in order to remove the circulating neurotoxins and to provide additional time for liver regeneration. Both patients awoke from the coma following treatment. One patient recovered completely, the other died on the second day as a result of massive gastro-intestinal bleeding. The clinical value and the technical problems of the procedure are investigated.
Zusammenfassung
Zwei Patienten mit einer fulminanten Lebernekrose, die sich im Koma Stadium IV befanden, wurden mit einer schnellen Infusion einer gekühlten, gepufferten Albumin-Elektrolytlösung und gleichzeitigen Ganzkörper-Spülung behandelt, um die zirkulierenden Neurotoxine zu entfernen und zusätzlich Zeit für die Leberregeneration zu gewinnen. Nach der Behandlung erwachten beide Patienten aus dem Koma. Ein Patient erholte sich vollständig, der andere starb am zweiten Tag an den Folgen einer massiven Magen-Darm-Blutung. Die klinische Bedeutung und die technischen Probleme des Verfahrens werden untersucht.
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Balestrieri, G.G., Manzillo, G., Spampinato, N. et al. Total body wash-out in patients with fulminant hepatitis. Infection 5, 95–97 (1977). https://doi.org/10.1007/BF01642088
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DOI: https://doi.org/10.1007/BF01642088