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Mossor-ostrowska J - One of the best experts on this subject based on the ideXlab platform.

  • Plasmapheresis in the treatment of Hepatic Coma
    Polski tygodnik lekarski (Warsaw Poland : 1960), 1992
    Co-Authors: Chrostek-maj J, Wiernikowski A, Caban J, Mossor-ostrowska J
    Abstract:

    Fourteen patients, including 6 with viral hepatitis B and 8 with liver cirrhosis were treated with plasmapheresis for Hepatic Coma. Altogether 29 plasmaphereses were carried out. Complete recovery was achieved in one patient with viral hepatitis B and in 3 patients with liver cirrhosis. Plasmapheresis should be performed in patients with severe lesions to the liver. Classification of patients to the treatment should include clinical examination, biochemical and enzymatic tests, and evaluation of liver reserve with isotope hepatography. In case of the acute poisoning with hepatotoxic agents indications to plasmapheresis should be evaluated from the toxicologic point of view.

Søndergaard O - One of the best experts on this subject based on the ideXlab platform.

  • Serum sodium as prognostic factor in Hepatic Coma
    Ugeskrift for laeger, 1993
    Co-Authors: Søndergaard O
    Abstract:

    UNLABELLED Among 17,628 discharges from the Department of Medical Gastroenterology, Odense University Hospital during the period 1 April 1973 to 31 May 1992, 66 (3.74/1000) discharges in 55 patients were found with the EDP-code 573.00 Coma Hepaticum. The case records of these patients were examined, and the lowest serum sodium values were compared between the patients who survived Hepatic Coma and those who did not and were correlated to the total duration of hospitalisation and the serum creatinine value measured at the same time as the lowest serum sodium value. The case records of 54 patients could be found, but in one case there was no serum sodium value; thus, the final material included 53 patients with 53 cases of Hepatic Coma and 53 lowest serum sodium values, 25 from patients who survived Hepatic Coma and 28 from patients who died. 15/28 (53.6%) lowest serum sodium values during fatal Coma admissions were 119 mmol/l or below, whereas 6/25 values during non-fatal Coma admissions were 119 mmol/l or below (p < 0.05). There was a negative correlation between the lowest measured serum sodium value and the total duration of hospitalisation (p < 0.00004). Exponential regression analysis showed negative correlation between serum creatinine and serum sodium (p = 0.0144). CONCLUSION The correlations mentioned above may raise the question whether serum sodium should be kept at 120 mmol/l or above in patients suffering from Hepatic Coma. It is not predictable whether such a measure will prevent or attenuate cerebral symptoms and improve survival rate.

Chrostek-maj J - One of the best experts on this subject based on the ideXlab platform.

  • Plasmapheresis in the treatment of Hepatic Coma
    Polski tygodnik lekarski (Warsaw Poland : 1960), 1992
    Co-Authors: Chrostek-maj J, Wiernikowski A, Caban J, Mossor-ostrowska J
    Abstract:

    Fourteen patients, including 6 with viral hepatitis B and 8 with liver cirrhosis were treated with plasmapheresis for Hepatic Coma. Altogether 29 plasmaphereses were carried out. Complete recovery was achieved in one patient with viral hepatitis B and in 3 patients with liver cirrhosis. Plasmapheresis should be performed in patients with severe lesions to the liver. Classification of patients to the treatment should include clinical examination, biochemical and enzymatic tests, and evaluation of liver reserve with isotope hepatography. In case of the acute poisoning with hepatotoxic agents indications to plasmapheresis should be evaluated from the toxicologic point of view.

Flemming Bendtsen - One of the best experts on this subject based on the ideXlab platform.

  • serum levels of short chain fatty acids in cirrhosis and Hepatic Coma
    Hepatology, 1991
    Co-Authors: Mette Rye Clausen, Per Brobech Mortensen, Flemming Bendtsen
    Abstract:

    Short-chain fatty acids cause reversible Coma in animals and may contribute to the pathogenesis of the Hepatic Coma in humans. The concentrations of short-chain fatty acids in peripheral venous blood were significantly elevated in 15 patients with Hepatic encephalopathy caused by cirrhosis (362 ± 83 μmol/L; mean ± S.E.M.) compared with 17 cirrhotic patients without encephalopathy (178 ± 57 μmol/L) and 11 normal individuals (60 ± 8 μmol/L). However, no correlation between the depth of Coma and the level of short-chain fatty acids was found after repetitive measurements in the Coma group. Compared with normal individuals, all short-chain fatty acids, except valerate, were elevated in patients with Hepatic encephalopathy, whereas only the concentrations of isobutyrate and isovalerate were significantly elevated in cirrhotic patients without encephalopathy. The concentrations of short-chain fatty acids in 21 nonencephalopathic cirrhotic patients who underwent catheterization were equally distributed in the aorta (187 ± 56 μmol/L), the Hepatic vein (212 ± 75 μmol/L), the azygos vein (140 ± 37 μmol/L) and the renal vein (135 ± 43 μmol/L) compared with peripheral venous blood (178 ± 57 μmol/L). This study does not support the idea that short-chain fatty acids are of major importance in the pathogenesis of Hepatic Coma in patients with cirrhosis. (HEPATOLOGY 1991;14:1040–1045.)

Simon K - One of the best experts on this subject based on the ideXlab platform.

  • Plasmapheresis in the treatment of Hepatic Coma complicating viral hepatitis
    Polski tygodnik lekarski (Warsaw Poland : 1960), 1992
    Co-Authors: Sciborski R, Zubkiewicz-usnarska L, Groehlich B, Burska-urbanowicz A, Simon K
    Abstract:

    Therapeutic plasmaphereses using CS 3000 Fenwal Cell Separator were performed in 4 women and 2 men, aged between 17 and 44 years, with Hepatic Coma complicating acute viral hepatitis type B. One to four plasma exchanges per patient were performed, usually at the volume of 3000 ml per procedure. Two patients at II and IVa period of the Coma, according to Aboun classification, survived. Four patients at II, III and two at III/IV period of the Coma died. The authors suggest that in some cases exchange of large volumes of plasma in the treatment of Hepatic Coma complicating acute viral hepatitis may be a lifesaving procedure.