Extracorporeal adsorption of protective and toxic bile acids and bilirubin in patients with cholestatic liver dysfunction: a prospective study
Authors' conclusion
Cytosorb® can adsorb bilirubin and toxic as well as protective BAs. However, a fast saturation of the adsorber resulting in a rapid decrease of the RR was observed. Furthermore, no relevant difference between hydrophobic toxic and hydrophilic protective BAs was detected regarding the adsorption amount.
Study context
- Population
- ICU patients with cholestatic liver dysfunction, continuous kidney replacement therapy, total bilirubin > 10 mg/dl, Cytosorb® (Cytosorb (CS)) in the dialysis circuit
- Participants
- 20 patients
- Outcome
- Relative reduction (RR, %) pre- vs post-CS
Main finding
As reported in the abstract
- Total bilirubin, median RR after initiation
- - 31.8%
- Conjugated bilirubin, median RR after initiation
- - 30.3%
- Total bilirubin, median RR after 6 h
- - 4.5%
- Conjugated bilirubin, median RR after 6 h
- - 4.8%
- GCA (toxic BA), initial RR
- - 97.4%
- TCA (toxic BA), initial RR
- - 94.9%
- GCDCA (toxic BA), initial RR
- - 82.5%
- TCDCA (toxic BA), initial RR
- - 86.0%
- GCA, RR after 6 h
- - 32.9%
- TCA, RR after 6 h
- - 32.7%
- GCDCA, RR after 6 h
- - 12.8%
- TCDCA, RR after 6 h
- - 14.3%
- UDCA (protective BA), RR after initiation
- - 77.7%
- GUDCA (protective BA), RR after initiation
- - 83.0%
- TUDCA (protective BA), RR after initiation
- - 91.3%
- UDCA, RR after 6 h
- - 7.4%
- GUDCA, RR after 6 h
- - 8.5%
- TUDCA, RR after 6 h
- - 12.5%
Observational data: associations, not effects.
Original publication
Extracorporeal adsorption of protective and toxic bile acids and bilirubin in patients with cholestatic liver dysfunction: a prospective study. Ann Intensive Care. Published 9 November 2023. doi:10.
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