Effect of the molecular adsorbent recirculating system and Prometheus devices on systemic haemodynamics and vasoactive agents in patients with acute-on-chronic alcoholic liver failure.docVIP

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Effect of the molecular adsorbent recirculating system and Prometheus devices on systemic haemodynamics and vasoactive agents in patients with acute-on-chronic alcoholic liver failure.doc

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Effect of the molecular adsorbent recirculating system and Prometheus devices on systemic haemodynamics and vasoactive agents in patients with acute-on-chronic alcoholic liver failure

Available online /content/10/4/R108 Research Open Access Vol 10 No 4 Effect of the molecular adsorbent recirculating system and Prometheus devices on systemic haemodynamics and vasoactive agents in patients with acute-on-chronic alcoholic liver failure Wim Laleman1, Alexander Wilmer2, Pieter Evenepoel3, Ingrid Vander Elst1, Marcel Zeegers1, Zahur Zaman4, Chris Verslype1, Johan Fevery1 and Frederik Nevens1 1Department of Hepatology, University Hospital Gasthuisberg, KU Leuven, Belgium 2Department of Medical Intensive Care, University Hospital Gasthuisberg, KU Leuven, Belgium 3Department of Nephrology, University Hospital Gasthuisberg, KU Leuven, Belgium 4Department of Laboratory Medicine, University Hospital Gasthuisberg, KU Leuven, Belgium Corresponding author: Frederik Nevens, frederik.nevens@uz.kuleuven.ac.be Received: 25 May 2006 Revisions requested: 26 Jun 2006 Revisions received: 29 Jun 2006 Accepted: 10 Jul 2006 Published: 19 Jul 2006 Critical Care 2006, 10:R108 (doi:10.1186/cc4985) This article is online at: /content/10/4/R108 ? 2006 Nevens et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Introduction Patients with acute-on-chronic liver failure show an aggravated hyperdynamic circulation. We evaluated, in a Prometheus decreased serum bilirubin levels (P 0.005 versus SMT), the Prometheus device being more effective than MARS (P = 0.002). Only MARS showed significant improvement in the mean arterial pressure (?change, +9 ± 2.4 mmHg versus -0.3 ± 2.4 mmHg with Prometheus and -5.2 ± 2.1 mmHg with SMT, P controlled haemodynamics manner, induced potential by changes in systemic adsorbent the molecular recirculating system (MARS) and the Prometheus system liver detoxification devices in a group