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Prometheus in the treatment of acute liver failure in experiment in large laboratory animal

Publication |
2007

Abstract

The aim of the study: The goal of the study is to evaluate the effect of new non-biological elimination-fractioned plasmatic separation and adsorption (FPSA) by Prométheus equipment in acute liver failure in the experiment of pigs. Methods: Acute liver failure was performed by surgical liver devascularization with portocaval shunt in 14 pigs the weight of 35-40 kg and to join to FPSA.

Values of liver failure indicators were measured, ICP including. The results were compared to control group of 7 pigs with acute liver failure without FPSA.

Data were statistically worked-up by Mann-Whitney rank test. Results: Level of serum bilirubin in experimental group to compare to control group was significantly lower (p < 0.01): at 6 hour 12.81 +- 6.54 vs. 29.84 +- 9.99 at 9.hour 11.94 +- 4.14 vs. 29.95 +- 12.36 and at 12.hour 13.88 +- 6.31 vs. 26.10 +- 12.23 mmol/1.

Significant difference in ammonia serum level was not founded. The intracranial pressure (ICP) was significantly different from 9.hour to 12.hour in favour of FPSA group (p < 0.01): 9.hour 19.1 +- 4.09 vs. 24.1 +- 2.85, l0.hour 21.9 +- 3.63 vs. 25.1 +- 2.19, ll.hour 22.5 +- 3.98 vs. 26.3 +- 3.50 and 12.hour 24.0 +- 4.66 vs. 29.8 +- 5.88 mm Hg.

Bilirubin level expressed by AUC in control and experimental group confirmed significant difference (p < 0.01): 293.2 +- 107.8 vs. 144.1 +- 59.6, values of AUC were non-significant: 3744.8 +- 1814.4 vs. 3043.7 +- 800.1 (ns.). The comparison of ICP values by AUC confirmed significant difference in control and experimental group (p < 0.05): 157.7 +- 10.25 vs. 138.4 +- 30.3.

Conclusion: The significant decrease of serum bilirubin and value of intracranial pressure were evaluated in the experimental acute liver failure in pigs treated by Prométheus-fractioned plasmatic separation and adsorption. Prométheus is effective in the treatment of acute liver failure.