Hypoxic hepatitis (HH) is a severe complication of postoperative low output syndrome, associated with high mortality rates despite appropriate drug therapy. Recently several extracorporeal supportive techniques have become available. We describe the case of a 70-year-old woman who developed HH secondary to cardiogenic shock after cardiac surgery. CPFA proved to be a valid tool for concomitant hemodynamic support and organ replacement therapy.
FuhrmannV, KneidingerN, HerknerH, Hypoxic hepatitis: underlying conditions and risk factors for mortality in critically ill patients.Intensive Care Med2009; 35: 1397-1405.
2.
VincentJL, MorenoR, TakalaJ, The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group of Sepsis-Related Problems of the European Society of Intensive Care Medicine.Intensive Care Med1996; 22: 707–10.
3.
MehtaRL, KellumJA, ShahSV, ; Acute Kidney Injury Network. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury.Crit Care2007; 11: R31.
4.
BellomoR, RoncoC.Indications and criteria for initiating renal replacement therapy in the intensive care unit.Kidney Int Suppl1998; 66: S106–9.
5.
BellomoR, BaldwinI, ColeL, RoncoC.Preliminary experience with high volume hemofiltration in human septic shock.Kidney Int Suppl1998; 66: S182–5.
6.
ReevesJH, ButtWW, ShannF, Continuous plasmafiltration in sepsis syndrome.Crit Care Med1999; 27: 2096–104.
7.
FormicaM, OlivieriC, LivigniS, Hemodynamic response to coupled plasmafiltration-adsorption in human septic shock.Intensive Care Med2003; 29: 703–8.
8.
AntonelliM, LevyM, AndrewsPJ, Hemodynamic monitoring in shock and implications for management.International Consensus Conference, Paris, France, 27–28 April 2006. Intensive Care Med 2007; 33: 575–90.
9.
HeCS, ShiW, YeZM, Efficacy and safety of coupled plasma filtration adsorption combined with continuous veno-venous hemofiltration for multiple organ dysfunction syndrome patients with acute liver failure.Zhongguo Wei Zhong Bing Ji Jiu Yi Xue2007; 19: 47–9.
10.
NashefSAM, RoquesF, MichelP, GauducheauE, LemeshowS, SalamonR.the EuroSCORE study group European system for cardiac operative risk evaluation (EuroSCORE).Eur J Cardiothorac Surg1999; 16: 9–13.
11.
GeppertA, SteinerA, ZornG, Multiple organ failure in patients with cardiogenic shock is associated with high plasma levels of interleukin-6.Crit Care Med2002; 30: 1987–94.
12.
ParkM, MacielAT, NoritomiDT, Is persistent hypotension after transient cardiogenic shock associated with an inflammatory response?Braz J Med Biol Res2008; 41: 648–56.
13.
DebrunnerM, SchuikiE, MinderE, Proinflammatory cytokines in acute myocardial infarction with and without cardiogenic shock.Clin Res Cardiol2008; 97: 298–305.
14.
CabréL, ManceboJ, SolsonaJF, Martín MC and the Bioethics Working Group of the SEMICyUC. Multi-center study of the multiple organ dysfunction syndrome in intensive care units: the usefulness of Sequential Organ Failure Assessment scores in decision making.Intensive Care Med2005; 31: 927–33.
15.
BoyleM, KurtovicJ, BihariD, RiordanS, SteinerC.Equipment review: The molecular adsorbents recirculating system (MARS®).Crit Care2004; 8: 280–6.