Modular extracorporeal life support for multiorgan failure patients

Giles J. Peek, Hilliary M. Killer, Marcin A. Sosnowski, Richard K. Firmin

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Adults receiving respiratory Extracorporeal Membrane Oxygenation (ECMO) have 66% survival. Nonsurvivors develop multisystem organ failure (MSOF). Once hepatic failure develops, death usually follows shortly. Serum bilirubin > 300 μmol/l predicted death with 87.8% sensitivity and 90.3% specificity in 41 adults who received ECMO in our institution during 1998 and 1999. No patients survive with a peak bilirubin > 400 μmol/l. The Molecular Adsorbent Recirculating System (MARS) is a cell-free extracorporeal liver support device; we hypothesized that using MARS in adult respiratory ECMO patients with a bilirubin > 300 μmol/l could improve survival in MSOF. The MARS was used in five such patients aged 19-56 who developed liver failure secondary to a respiratory illness. Mean peak bilirubin was 529 μmol/l and the lowest peak bilirubin was 436 μmol/l. Patients received between 1 and 8 MARS treatments, mean reduction in serum bilirubin for each patient ranging between 30 and 162 μmol/l. Two of five patients survived (40%), survivors showing the greatest reduction in serum bilirubin in response to MARS. All patients would have been expected to die according to our previous experience. We believe that MARS may prove a useful therapy for patients with MSOF.

Original languageEnglish (US)
Pages (from-to)69-71
Number of pages3
JournalLiver
Volume22
Issue numberSUPPL. 2
DOIs
StatePublished - 2002
Externally publishedYes

Fingerprint

Extracorporeal Membrane Oxygenation
Bilirubin
Liver Failure
Serum
Survival
Survivors
Sensitivity and Specificity
Equipment and Supplies
Liver
Therapeutics

Keywords

  • ECMO
  • Hyperbilirubinaemia
  • MARS

ASJC Scopus subject areas

  • Hepatology

Cite this

Modular extracorporeal life support for multiorgan failure patients. / Peek, Giles J.; Killer, Hilliary M.; Sosnowski, Marcin A.; Firmin, Richard K.

In: Liver, Vol. 22, No. SUPPL. 2, 2002, p. 69-71.

Research output: Contribution to journalArticle

Peek, GJ, Killer, HM, Sosnowski, MA & Firmin, RK 2002, 'Modular extracorporeal life support for multiorgan failure patients', Liver, vol. 22, no. SUPPL. 2, pp. 69-71. https://doi.org/10.1034/j.1600-0676.2002.00014.x
Peek, Giles J. ; Killer, Hilliary M. ; Sosnowski, Marcin A. ; Firmin, Richard K. / Modular extracorporeal life support for multiorgan failure patients. In: Liver. 2002 ; Vol. 22, No. SUPPL. 2. pp. 69-71.
@article{43aace089bbd4f18a296bdc4e2e2e74c,
title = "Modular extracorporeal life support for multiorgan failure patients",
abstract = "Adults receiving respiratory Extracorporeal Membrane Oxygenation (ECMO) have 66{\%} survival. Nonsurvivors develop multisystem organ failure (MSOF). Once hepatic failure develops, death usually follows shortly. Serum bilirubin > 300 μmol/l predicted death with 87.8{\%} sensitivity and 90.3{\%} specificity in 41 adults who received ECMO in our institution during 1998 and 1999. No patients survive with a peak bilirubin > 400 μmol/l. The Molecular Adsorbent Recirculating System (MARS) is a cell-free extracorporeal liver support device; we hypothesized that using MARS in adult respiratory ECMO patients with a bilirubin > 300 μmol/l could improve survival in MSOF. The MARS was used in five such patients aged 19-56 who developed liver failure secondary to a respiratory illness. Mean peak bilirubin was 529 μmol/l and the lowest peak bilirubin was 436 μmol/l. Patients received between 1 and 8 MARS treatments, mean reduction in serum bilirubin for each patient ranging between 30 and 162 μmol/l. Two of five patients survived (40{\%}), survivors showing the greatest reduction in serum bilirubin in response to MARS. All patients would have been expected to die according to our previous experience. We believe that MARS may prove a useful therapy for patients with MSOF.",
keywords = "ECMO, Hyperbilirubinaemia, MARS",
author = "Peek, {Giles J.} and Killer, {Hilliary M.} and Sosnowski, {Marcin A.} and Firmin, {Richard K.}",
year = "2002",
doi = "10.1034/j.1600-0676.2002.00014.x",
language = "English (US)",
volume = "22",
pages = "69--71",
journal = "Liver International",
issn = "1478-3223",
publisher = "Wiley-Blackwell",
number = "SUPPL. 2",

}

TY - JOUR

T1 - Modular extracorporeal life support for multiorgan failure patients

AU - Peek, Giles J.

AU - Killer, Hilliary M.

AU - Sosnowski, Marcin A.

AU - Firmin, Richard K.

PY - 2002

Y1 - 2002

N2 - Adults receiving respiratory Extracorporeal Membrane Oxygenation (ECMO) have 66% survival. Nonsurvivors develop multisystem organ failure (MSOF). Once hepatic failure develops, death usually follows shortly. Serum bilirubin > 300 μmol/l predicted death with 87.8% sensitivity and 90.3% specificity in 41 adults who received ECMO in our institution during 1998 and 1999. No patients survive with a peak bilirubin > 400 μmol/l. The Molecular Adsorbent Recirculating System (MARS) is a cell-free extracorporeal liver support device; we hypothesized that using MARS in adult respiratory ECMO patients with a bilirubin > 300 μmol/l could improve survival in MSOF. The MARS was used in five such patients aged 19-56 who developed liver failure secondary to a respiratory illness. Mean peak bilirubin was 529 μmol/l and the lowest peak bilirubin was 436 μmol/l. Patients received between 1 and 8 MARS treatments, mean reduction in serum bilirubin for each patient ranging between 30 and 162 μmol/l. Two of five patients survived (40%), survivors showing the greatest reduction in serum bilirubin in response to MARS. All patients would have been expected to die according to our previous experience. We believe that MARS may prove a useful therapy for patients with MSOF.

AB - Adults receiving respiratory Extracorporeal Membrane Oxygenation (ECMO) have 66% survival. Nonsurvivors develop multisystem organ failure (MSOF). Once hepatic failure develops, death usually follows shortly. Serum bilirubin > 300 μmol/l predicted death with 87.8% sensitivity and 90.3% specificity in 41 adults who received ECMO in our institution during 1998 and 1999. No patients survive with a peak bilirubin > 400 μmol/l. The Molecular Adsorbent Recirculating System (MARS) is a cell-free extracorporeal liver support device; we hypothesized that using MARS in adult respiratory ECMO patients with a bilirubin > 300 μmol/l could improve survival in MSOF. The MARS was used in five such patients aged 19-56 who developed liver failure secondary to a respiratory illness. Mean peak bilirubin was 529 μmol/l and the lowest peak bilirubin was 436 μmol/l. Patients received between 1 and 8 MARS treatments, mean reduction in serum bilirubin for each patient ranging between 30 and 162 μmol/l. Two of five patients survived (40%), survivors showing the greatest reduction in serum bilirubin in response to MARS. All patients would have been expected to die according to our previous experience. We believe that MARS may prove a useful therapy for patients with MSOF.

KW - ECMO

KW - Hyperbilirubinaemia

KW - MARS

UR - http://www.scopus.com/inward/record.url?scp=0036383741&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036383741&partnerID=8YFLogxK

U2 - 10.1034/j.1600-0676.2002.00014.x

DO - 10.1034/j.1600-0676.2002.00014.x

M3 - Article

VL - 22

SP - 69

EP - 71

JO - Liver International

JF - Liver International

SN - 1478-3223

IS - SUPPL. 2

ER -