Hemoadsorption Therapy for Critically Ill Patients with Acute Liver Dysfunction: A Meta-Analysis and Systematic Review
Critically ill patients are at risk of developing acute liver dysfunction as part of multiorgan failure sequelae. Clearing the blood from toxic liver-related metabolites and cytokines could prevent further organ damage. Despite the increasing use of hemoadsorption for this purpose, evidence of its e...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/12/1/67 |
| _version_ | 1827369811585269760 |
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| author | Caner Turan Csenge Erzsébet Szigetváry Tamás Kói Marie Anne Engh Işıl Atakan László Zubek Tamás Terebessy Péter Hegyi Zsolt Molnár |
| author_facet | Caner Turan Csenge Erzsébet Szigetváry Tamás Kói Marie Anne Engh Işıl Atakan László Zubek Tamás Terebessy Péter Hegyi Zsolt Molnár |
| author_sort | Caner Turan |
| collection | DOAJ |
| description | Critically ill patients are at risk of developing acute liver dysfunction as part of multiorgan failure sequelae. Clearing the blood from toxic liver-related metabolites and cytokines could prevent further organ damage. Despite the increasing use of hemoadsorption for this purpose, evidence of its efficacy is lacking. Therefore, we conducted this systematic review and meta-analysis to assess the evidence on clinical outcomes following hemoadsorption therapy. A systematic search conducted in six electronic databases (PROSPERO registration: CRD42022286213) yielded 30 eligible publications between 2011 and 2023, reporting the use of hemoadsorption for a total of 335 patients presenting with liver dysfunction related to acute critical illness. Of those, 26 are case presentations (<i>n</i> = 84), 3 are observational studies (<i>n</i> = 142), and 1 is a registry analysis (<i>n</i> = 109). Analysis of data from individual cases showed a significant reduction in levels of aspartate transaminase (<i>p</i> = 0.03) and vasopressor need (<i>p</i> = 0.03) and a tendency to lower levels of total bilirubin, alanine transaminase, C-reactive protein, and creatinine. Pooled data showed a significant reduction in total bilirubin (mean difference of −4.79 mg/dL (95% CI: −6.25; −3.33), <i>p</i> = 0.002). The use of hemoadsorption for critically ill patients with acute liver dysfunction or failure seems to be safe and yields a trend towards improved liver function after therapy, but more high-quality evidence is crucially needed. |
| first_indexed | 2024-03-08T09:58:00Z |
| format | Article |
| id | doaj.art-98b945c9fb5b4248ba7e83ae3f8c6b0a |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-08T09:58:00Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-98b945c9fb5b4248ba7e83ae3f8c6b0a2024-01-29T13:46:52ZengMDPI AGBiomedicines2227-90592023-12-011216710.3390/biomedicines12010067Hemoadsorption Therapy for Critically Ill Patients with Acute Liver Dysfunction: A Meta-Analysis and Systematic ReviewCaner Turan0Csenge Erzsébet Szigetváry1Tamás Kói2Marie Anne Engh3Işıl Atakan4László Zubek5Tamás Terebessy6Péter Hegyi7Zsolt Molnár8Department of Anesthesiology and Intensive Therapy, Semmelweis University, 1085 Budapest, HungaryDepartment of Anesthesiology and Intensive Therapy, Semmelweis University, 1085 Budapest, HungaryCentre for Translational Medicine, Semmelweis University, 1085 Budapest, HungaryCentre for Translational Medicine, Semmelweis University, 1085 Budapest, HungaryCentre for Translational Medicine, Semmelweis University, 1085 Budapest, HungaryCentre for Translational Medicine, Semmelweis University, 1085 Budapest, HungaryCentre for Translational Medicine, Semmelweis University, 1085 Budapest, HungaryCentre for Translational Medicine, Semmelweis University, 1085 Budapest, HungaryDepartment of Anesthesiology and Intensive Therapy, Semmelweis University, 1085 Budapest, HungaryCritically ill patients are at risk of developing acute liver dysfunction as part of multiorgan failure sequelae. Clearing the blood from toxic liver-related metabolites and cytokines could prevent further organ damage. Despite the increasing use of hemoadsorption for this purpose, evidence of its efficacy is lacking. Therefore, we conducted this systematic review and meta-analysis to assess the evidence on clinical outcomes following hemoadsorption therapy. A systematic search conducted in six electronic databases (PROSPERO registration: CRD42022286213) yielded 30 eligible publications between 2011 and 2023, reporting the use of hemoadsorption for a total of 335 patients presenting with liver dysfunction related to acute critical illness. Of those, 26 are case presentations (<i>n</i> = 84), 3 are observational studies (<i>n</i> = 142), and 1 is a registry analysis (<i>n</i> = 109). Analysis of data from individual cases showed a significant reduction in levels of aspartate transaminase (<i>p</i> = 0.03) and vasopressor need (<i>p</i> = 0.03) and a tendency to lower levels of total bilirubin, alanine transaminase, C-reactive protein, and creatinine. Pooled data showed a significant reduction in total bilirubin (mean difference of −4.79 mg/dL (95% CI: −6.25; −3.33), <i>p</i> = 0.002). The use of hemoadsorption for critically ill patients with acute liver dysfunction or failure seems to be safe and yields a trend towards improved liver function after therapy, but more high-quality evidence is crucially needed.https://www.mdpi.com/2227-9059/12/1/67hemoadsorptionliver dysfunctioncritical caredatabase meta-analysis |
| spellingShingle | Caner Turan Csenge Erzsébet Szigetváry Tamás Kói Marie Anne Engh Işıl Atakan László Zubek Tamás Terebessy Péter Hegyi Zsolt Molnár Hemoadsorption Therapy for Critically Ill Patients with Acute Liver Dysfunction: A Meta-Analysis and Systematic Review Biomedicines hemoadsorption liver dysfunction critical care database meta-analysis |
| title | Hemoadsorption Therapy for Critically Ill Patients with Acute Liver Dysfunction: A Meta-Analysis and Systematic Review |
| title_full | Hemoadsorption Therapy for Critically Ill Patients with Acute Liver Dysfunction: A Meta-Analysis and Systematic Review |
| title_fullStr | Hemoadsorption Therapy for Critically Ill Patients with Acute Liver Dysfunction: A Meta-Analysis and Systematic Review |
| title_full_unstemmed | Hemoadsorption Therapy for Critically Ill Patients with Acute Liver Dysfunction: A Meta-Analysis and Systematic Review |
| title_short | Hemoadsorption Therapy for Critically Ill Patients with Acute Liver Dysfunction: A Meta-Analysis and Systematic Review |
| title_sort | hemoadsorption therapy for critically ill patients with acute liver dysfunction a meta analysis and systematic review |
| topic | hemoadsorption liver dysfunction critical care database meta-analysis |
| url | https://www.mdpi.com/2227-9059/12/1/67 |
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