IngentaConnect The Series-parallel Circuit in the Treatment of Fulminant Hepatit...

Authors: Nakae, Hajime; Yonekawa, Chikara¹; Moon, Sunkwi¹; Tajimi, Kimitaka¹

Source: Therapeutic Apheresis and Dialysis, Volume 8, Number 2, April 2004 , pp. 153-159(7)

Abstract:

We developed a series-parallel treatment method for combined plasma exchange (PE) and continuous hemodiafiltration (CHDF) therapy in fulminant hepatitis. We then compared total serum bilirubin, citrate, and cytokine levels obtained by the new methods to those obtained with treatment by the single and reverse-parallel PE methods. Ten adult patients with fulminant hepatitis consented to participate. Plasma exchange was conducted 25 times by the single method (PE only), 16 times by the reverse-parallel method, and 37 times by the series-parallel method. The percentage of total bilirubin removed was highest with the single method followed in order by that with the series-parallel and reverse-parallel methods; the differences were significant. The percentage increase in citrate level was highest with the single method, followed in order by that with the series-parallel and the reverse-parallel methods; these differences were also significant. There was no significant difference in serum interleukin (IL)-6 levels after PE, by the single or the reverse-parallel methods. However, the IL-6 level decreased significantly following PE by the series-parallel method. The serum IL-18 level decreased significantly following PE by each of the three methods. Thus, removal of excess bilirubin, citrate, and cytokines by the series-parallel method, a simple maneuver with excellent removal rates, was considered effective.

Keywords: Continuous hemodiafiltration; Plasma exchange; Series-parallel circuit

Document Type: Research article

DOI: 10.1111/j.1526-0968.2003.00125.x

Affiliations: 1: Department of Integrated Medicine, Division of Emergency and Critical Care Medicine, Akita University School of Medicine, Akita, Japan

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The Series-parallel Circuit in the Treatment of Fulminant Hepatitis