title: Fractionated plasmatic separation and adsorption does not alter haemodynamic parameters in experimental acute liver failure.
abstract: OBJECTIVE
  Acute liver failure (ALF) is a rare disease with a bad prognosis. Its start is accompanied by haemodynamic instability. The aim of our study was to evaluate the influence of fractionated plasmatic separation and adsorption (FPSA) on body haemodynamics using a large animal experimental model of ALF.
  
  
  METHODS
  ALF was induced by the devascularisation of 21 laboratory pigs. FPSA was applied in 14 animals and seven animals formed a control group. Values of systemic vascular resistance index (SVRI), heart rate (HR), pulmonary artery wedge pressure (PAWP) and cardiac index (CI) at hours 3, 6, 9 and 12 of the experiment were compared. The values from laboratory tests conducted with FPSA-treated vs. untreated ALF animals were compared using Student's t-test, paired or unpaired, as required, and Mann-Whitney U-test using EXCEL and QUATRO spreadsheet applications.
  
  
  RESULTS
  We found no significant differences in mean arterial pressure, SVRI, or plasma lactate (p>0.05) in the FPSA-treated group but there was a significant decrease(p<0.05) in intracranial pressure (ICP). Furthermore, we observed a significant decrease in HR at hour 3. A significant increase in CI at hour 9 and a significant decrease in pulmonary artery wedge pressure at hours 6 and 12 were also observed.
  
  
  CONCLUSIONS
  Our study of FPSA application (Prometheus device) for treatment of experimental ALF in a large animal model did not confirm the earlier reported development of changes in body haemodynamics.
authors.affiliation: Department of Anaesthesiology, Resuscitation, and Intensive Care, 1st Faculty of Medicine and General Faculty Hospital, Charles University, Prague, Czech Republic.
authors.forename: Eva
authors.initials: E
authors.lastname: Laszikova
authors.affiliation: Anaesthesiology, Resuscitation and Intensive Care Clinic, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Josef
authors.initials: J
authors.lastname: Prazak
authors.affiliation: Department of Surgery, 2nd Faculty of Medicine, Charles University and Central Military Hospital, Prague, Czech Republic.
authors.forename: Ondrej
authors.initials: O
authors.lastname: Ryska
authors.affiliation: Department of Surgery, 2nd Faculty of Medicine, Charles University and Central Military Hospital, Prague, Czech Republic.
authors.forename: Eva
authors.initials: E
authors.lastname: Koblihova
authors.affiliation: Department of Anaesthesiology, Resuscitation, and Intensive Care, 1st Faculty of Medicine and General Faculty Hospital, Charles University, Prague, Czech Republic.
authors.forename: Tomas
authors.initials: T
authors.lastname: Tyll
authors.affiliation: Department of Surgery, 2nd Faculty of Medicine, Charles University and Central Military Hospital, Prague, Czech Republic.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Ryska
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D017583:Hemodiafiltration / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D006439:Hemodynamics / Q000502:physiology*; D017114:Liver Failure, Acute / Q000503:physiopathology / Q000628:therapy*; D013552:Swine