Liver-Support Therapies in Critical Illness—A Comparative Analysis of Procedural Characteristics and Safety

Extracorporeal liver-support therapies remain controversial in critically ill patients, as most studies have failed to show an improvement outcomes. However, heterogeneous timing and inclusion criteria, insufficient number of treatments, the lack a situation-dependent selection available modalities may contributed negative study results. We retrospectively investigated procedural characteristics safety three CytoSorb, Molecular Adsorbent Recirculating System (MARS) therapeutic plasma exchange (TPE). Whereas TPE had its strengths shorter treatment duration, clearing larger molecules, affecting platelet numbers less, improving systemic coagulation hemodynamics, CytoSorb MARS were associated with superior reduction particularly small protein-bound water-soluble substances. The clearance magnitude was concentration-dependent for all therapies, but additionally related molecular weight therapy. Severe complications did not appear. In conclusion, better characterization disease-driving well beneficial molecules patients acute liver dysfunction is crucial improve use therapy patients. be at high risk bleeding impaired synthesis while considered whom elimination smaller toxic compounds primary objective.