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Journal of Intensive Care Medicine, Vol. 21, No. 6, 369-371 (2006)
DOI: 10.1177/0885066606293384
© 2006 SAGE Publications

Use of Molecular Adsorbent Recirculating System in Acute Liver Failure Attributable to Dengue Hemorrhagic Fever

Alvin Penafiel, MD, FPCP

Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore, agp1502{at}aim.com

Anantham Devanand, MBBS, MRCP

Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore

Han Khim Tan, MBBS, MRCP

Department of Renal Medicine, Singapore General Hospital, Singapore

Philip Eng, FCCP, FACP

Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore

Fulminant liver failure is an uncommon but life-threatening complication of severe dengue infection. Molecular adsorbent recirculating system (MARS), which reverses hepatic encephalopathy, is an emerging important element in the armamentarium of organ support in the intensive care unit in patients suffering from acute liver failure. We report an intensive care unit case of fulminant liver failure secondary to dengue hemorrhagic fever, which was supported with MARS. MARS led to rapid reversal of biochemical profile and encephalopathy, resulting in early extubation and intensive care unit discharge.

Key Words: molecular adsorbent recirculating system • acute liver failure • liver dialysis • dengue

References

  • Sam K, Ib G, Prv K. Epidemiology, clinical features, laboratory investigations and early diagnosis of dengue fever in adults: a descriptive study in Sri Lanka. Southeast Asian J Trop Med Public Health. 2005;36: 686-692.[Medline] [Order article via Infotrieve]
  • Innis BL, Myint KSA, Nisalak A, et al. Acute liver failure is one important cause of fatal dengue infection. Southeast Asian J Trop Med Public Health. 1990;21: 695-696.
  • Bethell DB, Flobbe K, Phuong CX, et al. Pathophysiologic and prognostic role of cytokines in dengue hemorrhagic fever. J Infect Dis. 1998;177: 778-782.[Medline] [Order article via Infotrieve]
  • Rosen L, Khin MM. Recovery of virus from the liver of children with fatal dengue: reflection on the pathogenesis of the disease and its possible analogy with that of yellow fever. Res Virol. 1989;140: 351-360.[Medline] [Order article via Infotrieve]
  • Marianneau P, Cardona A, Edelman L, et al. Dengue virus replication in human hepatoma cells activates NF-kB which in turn induces apoptotic cell death. J Virol. 1997;71: 3244-3249.[Abstract]
  • Shakil AO, Kramen D, Mazariegos GV, et al. Acute liver failure: clinical features, outcome analysis, and applicability of prognostic criteria. Liver Transpl. 2000;6: 163-169.[Medline] [Order article via Infotrieve]
  • Barshes N, Gay AN, Williams B, et al. Support for the acutely failing liver: a comprehensive review of historic and contemporary strategy. J Am Coll Surg. 2005;201: 458-476.[CrossRef][Medline] [Order article via Infotrieve]
  • Larsen FS, Hansen BA, Blei AT, et al. Intensive care management of patients with acute liver failure with emphasis on systemic hemodynamic instability and cerebral edema: a critical appraisal of pathophysiology. Can J Gastroenterol. 2000;14: 105-111.
  • Pless G, Sauer IM. Bioartificial liver: current status. Transplant Proc. 2005;37: 3893-3895.[CrossRef][Medline] [Order article via Infotrieve]
  • Tan HK. Molecular adsorbent recirculating system (MARS). Ann Acad Med Singapore. 2004;33: 329-335.[Medline] [Order article via Infotrieve]
  • Mitzner SR, Stange J, Klammt S, et al. Extracorporeal detoxification using the molecular adsorbent recirculating system for critically ill patients with liver failure. J Am Soc Nephrol. 2001;12: S75-S82.[Abstract/Free Full Text]
  • Di Campli C, Zocco MA, Gaspari R, et al. The decrease in cytokine concentration during albumin dialysis correlates with the prognosis of patients with acute on chronic liver failure. Transpl Proc. 2005;37: 2551-2553.[CrossRef][Medline] [Order article via Infotrieve]
  • Kjaergard L, Liu J, Als-Nielsen B, et al. Artificial and bioartificial support systems for acute and acute-on-chronic liver failure. JAMA. 2003;289: 217-222.[Abstract/Free Full Text]
  • Mitzner SR, Strange J, Klammt S, et al. Improvement of hepatorenal syndrome with extracorporeal albumin dialysis MARS: result of a prospective, randomized, controlled clinical trial. Liver Transpl. 2000;6: 277-286.[CrossRef][Medline] [Order article via Infotrieve]
  • Heemann U, Treichel U, Loock J, et al. Albumin dialysis in cirrhosis with superimposed acute liver injury: a prospective controlled study. Hepatol. 2002;36: 949-958.[Medline] [Order article via Infotrieve]
  • Koivusalo AM, Vakkuri A, Hockerstedt K, et al. Experience of MARS therapy with and without transplantation in 101 patients with liver insufficiency. Transplant Proc. 2005;37: 3315-3317.[CrossRef][Medline] [Order article via Infotrieve]
  • Steiner C, Zinggrebe A, Vertler A. Experiences with MARS therapy in liver disease: analysis of 385 patients of the International MARS Registry. Hepatology. 2003;38: 239A-239A.

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This Article
Right arrow Abstract Freely available
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Right arrow Alert me when this article is cited
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Right arrow Email this article to a friend
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Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Penafiel, A.
Right arrow Articles by Eng, P.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Penafiel, A.
Right arrow Articles by Eng, P.
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 Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?