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Observational Study
. 2021 May 13;11(1):10190.
doi: 10.1038/s41598-021-89712-4.

Successful elimination of bilirubin in critically ill patients with acute liver dysfunction using a cytokine adsorber and albumin dialysis: a pilot study

Christina Scharf  1 , Uwe Liebchen  2 , Michael Paal  3 , Andrea Becker-Pennrich  2 , Michael Irlbeck  2 , Michael Zoller  2 , Ines Schroeder  2
Affiliations
Observational Study

Successful elimination of bilirubin in critically ill patients with acute liver dysfunction using a cytokine adsorber and albumin dialysis: a pilot study

Christina Scharf et al. Sci Rep. .

Abstract

There are different methods of artificial liver support for patients with acute liver dysfunction (ALD). However, CytoSorb (CS) might be a new approved option for those patients. Question of interest is whether the elimination performance of CS was comparable to that of advanced organ support (ADVOS). Patients, treated with CS (integrated into high-flux dialysis) or ADVOS and a total bilirubin > 10 mg/dl were included. Laboratory parameters were evaluated before starting therapy (d0) and 12-24 h thereafter (d1). The Wilcoxon-test with associated samples was used for statistical analysis. Thirty-nine patients (33 CS, 6 ADVOS) were included. The median bilirubin at d0 was 16.9 and 17.7 mg/dl and at d1 was 13.2 and 15.9 mg/dl, in the CS and ADVOS group, respectively. There was a significant bilirubin reduction as well in the CS group (p < 0.001, median relative reduction: 22.5%) as in the ADVOS group (p = 0.028, median relative reduction: 22.8%). There was no significant difference in the relative bilirubin reduction between CS and ADVOS therapies. The use of CytoSorb and ADVOS in patients with ALD led to a significant and comparable decrease in total bilirubin. The easy use of CS might be an advantage compared to other procedures.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Selection of the study population. CS: CytoSorb, ADVOS: advanced organ support.
Figure 2
Figure 2
Development and relative reduction in bilirubin levels in patients with CytoSorb and ADVOS therapy. d–1: day before treatment, d0: shortly before treatment, d1: directly after treatment, CS: CytoSorb, ADV: advanced organ support; orange line represents the median, grey boxes the interquartile range and the whiskers are limited to 1.5 times the interquartile range.
See this image and copyright information in PMC

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