title: Biochemical correlates of reversal of hepatic coma coated with charcoal hemoperfusion.
abstract: Ten patients in stage IV hepatic encephalopathy who had not responded to conventional therapy for at least 48 hrs were treated with one or more 4 hr periods of hemoperfusion. Nine (90%) awoke, and 4 (40%) are alive to date, the survivors having acutely toxic and infective hepatic lesions. Biochemical changes that occurred were a reduction in blood ammonia of 23%, a rise in the ratio of branched chain to aromatic amino acids in blood (1.08 +/- 0.3 to 1.3 +/- 0.4), and cerebrospinal fluid (0.26 +/- 0.02 to 0.32 to 0.03), and a rise in cerebrospinal fluid cAMP from 2.3 +/- 0.7 ng/ml to 3.4 +/- 1.29 ng/ml with hemoperfusion. Administration of platelets and fresh frozen plasma restored the reduction of platelet counts of 29% towards pretreatment values.
mesh_terms: D000293:Adolescent; D000328:Adult; D000596:Amino Acids / Q000097:blood / Q000134:cerebrospinal fluid; D000641:Ammonia / Q000097:blood; D002395:Catecholamines / Q000134:cerebrospinal fluid; D002606:Charcoal / Q000627:therapeutic use*; D005260:Female; D006464:Hemoperfusion; D006501:Hepatic Encephalopathy / Q000628:therapy*; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000134:cerebrospinal fluid; D012701:Serotonin / Q000134:cerebrospinal fluid
chemical_list: D000596:Amino Acids; D002395:Catecholamines; D002606:Charcoal; D012701:Serotonin; D000641:Ammonia; D009638:Norepinephrine