Management of hepatic coma complicating viral hepatitis.

Abstract:

:The treatment is described of 17 patients with presumed viral hepatitis who developed hepatic coma unresponsive to standard conservative measures. Five patients were considered for treatment by exchange transfusion. Four were treated, with transient improvement in two, but all died. Nine patients were considered for treatment by heterologous liver perfusion. Six were treated, with transient improvement in two and complete recovery in one. The last patient remains well 12 months later. Dialysis in four patients had no effect on the coma; the addition of albumin to the dialysate did not increase the extraction of bilirubin. The clinical course in most cases was irregular. Complications were common, the most important being cerebral oedema with medullary coning, bleeding, bacterial infection, hypoglycaemia, and pancreatitis. Heterologous liver perfusion was the most efficient method of removing bilirubin. However, it is not yet clear whether it is more effective than exchange transfusion in the treatment of the patient.

journal_name

Gut

journal_title

Gut

authors

Pirola RC,Ham JM,Elmslie RG

doi

10.1136/gut.10.11.898

subject

Has Abstract

pub_date

1969-11-01 00:00:00

pages

898-903

issue

11

eissn

0017-5749

issn

1468-3288

journal_volume

10

pub_type

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