Nursing in critical care · 2026
Comparison of Two Artificial Liver Treatments for Acute Liver Failure: A Retrospective Observational Study.
СтатьяНаблюдательное исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Wu Xiulian, Wu Dongxia, Sun Xiaoqing, Wang Wenhui, Wei Jiayuan, Liu Xin, Gu Yanmei
Аннотация
BACKGROUND: Liver failure can lead to severe disorders in the body's metabolism, detoxification, synthesis and other functions, with a high mortality rate of 60%-90%. The dual plasma molecular adsorption system (DPMAS) is a new artificial liver technology that has received much attention in recent years. However, it cannot provide coagulation factors, albumin or other substances during the treatment process and may even consume albumin during the adsorption process. The DPMAS typically needs to be used in combination with plasma exchange (PE). Few studies have compared PE alone and DPMAS + PE.
AIM: This study aimed to explore the clinical efficacy and nursing methods of different artificial liver treatments for patients with acute drug-induced liver injury.
STUDY DESIGN: The clinical data of patients with liver failure admitted to the intensive care unit of our hospital were retrospectively analysed to identify a PE group and a sequential PE group, comprising DPMAS with PE (DPMAS + PE). The changes in liver function and coagulation function index before and after treatment and the occurrence of adverse reactions were compared.
RESULTS: In total, n = 57 patients (PE n = 14, DPMAS + PE n = 43) participated in the study. There was no significant difference in alanine aminotransferase (ALT), aspartate aminotransferase (AST) or total bilirubin (TBIL) levels before treatment (p > 0.05). After treatment, ALT levels were higher in the PE group than in the DPMAS + PE group (317.72 ± 604.24 vs. 276.02 ± 763.04, respectively), whereas TBIL levels were lower in the former than in the latter (237.91 ± 124.34 vs. 297.95 ± 153.38). The international normalised ratio (INR) was higher in the DPMAS + PE group than in the PE group (1.84 ± 0.66 vs. 1.66 ± 0.72) and prothrombin activity (30.51 ± 7.91 vs. 34.62 ± 8.43) was lower, indicating that DPMAS + PE had a better effect on ALT and AST levels, but PE alone was more effective in improving TBIL and INR levels.
CONCLUSIONS: The two artificial liver treatments can improve markers of liver function in patients with liver failure and help with liver function recovery.
RELEVANCE TO CLINICAL PRACTICE: Both artificial liver therapies effectively support patients awaiting transplantation. Successful management, particularly of the combined DPMAS + PE modality, demands specialised nursing expertise. Nurses must vigilantly monitor circuit pressure and coagulation parameters and adjust anticoagulant doses proactively to ensure treatment safety and efficacy.
AIM: This study aimed to explore the clinical efficacy and nursing methods of different artificial liver treatments for patients with acute drug-induced liver injury.
STUDY DESIGN: The clinical data of patients with liver failure admitted to the intensive care unit of our hospital were retrospectively analysed to identify a PE group and a sequential PE group, comprising DPMAS with PE (DPMAS + PE). The changes in liver function and coagulation function index before and after treatment and the occurrence of adverse reactions were compared.
RESULTS: In total, n = 57 patients (PE n = 14, DPMAS + PE n = 43) participated in the study. There was no significant difference in alanine aminotransferase (ALT), aspartate aminotransferase (AST) or total bilirubin (TBIL) levels before treatment (p > 0.05). After treatment, ALT levels were higher in the PE group than in the DPMAS + PE group (317.72 ± 604.24 vs. 276.02 ± 763.04, respectively), whereas TBIL levels were lower in the former than in the latter (237.91 ± 124.34 vs. 297.95 ± 153.38). The international normalised ratio (INR) was higher in the DPMAS + PE group than in the PE group (1.84 ± 0.66 vs. 1.66 ± 0.72) and prothrombin activity (30.51 ± 7.91 vs. 34.62 ± 8.43) was lower, indicating that DPMAS + PE had a better effect on ALT and AST levels, but PE alone was more effective in improving TBIL and INR levels.
CONCLUSIONS: The two artificial liver treatments can improve markers of liver function in patients with liver failure and help with liver function recovery.
RELEVANCE TO CLINICAL PRACTICE: Both artificial liver therapies effectively support patients awaiting transplantation. Successful management, particularly of the combined DPMAS + PE modality, demands specialised nursing expertise. Nurses must vigilantly monitor circuit pressure and coagulation parameters and adjust anticoagulant doses proactively to ensure treatment safety and efficacy.