Molecular Adsorbent Recirculating System (MARS®) in Hypoxic Hepatitis (MARS in HH)
Hypoxic Hepatitis, Ischemic Hepatitis, Shock Liver
About this trial
This is an interventional treatment trial for Hypoxic Hepatitis
Eligibility Criteria
Inclusion Criteria:
- presence of severe hypoxic hepatitis with aminotransferase levels > 40 times the upper limit of normal
- duration of hypoxic hepatitis more than 12 hours
- age >/= 18 years
Exclusion Criteria:
- age < 18 years
- pregnancy
- DNR - order
- liver cirrhosis
- Cardiopulmonary resuscitation with unknown neurological outcome and/or hypoxic brain damage
- Expected survival of less than 24 hours
Sites / Locations
- Medical University Vienna, Dpt. of Internal Medicine 3, Div. of Gastroenterology and HepatologyRecruiting
- University Medical Center Hamburg-EppendorfRecruiting
Arms of the Study
Arm 1
Arm 2
No Intervention
Experimental
Control
MARS-Group
Patients with severe HH will be treated with standard medical therapy (i.e. vasopressor support with norepinephrine in refractory hypotension = RR mean < 65 mmHg, positive inotropic support with dobutamine if the central venous oxygen saturation < 70%, renal replacement therapy in case of severe metabolic acidosis and/or renal failure, antibiotic treatment in case of suspected or proven infection, mechanical ventilation in case of severe hypoxemia or hypercapnia and/or GCS <= 8.
20 patients will be allocated by randomization to the MARS arm. Additionally to standard medical therapy they will receive 4 MARS sessions on three consecutive days, MARS® therapy will be applied for at least 12 hours per session. Thereafter, MARS® treatment will be continued if the patient still has increasing aminotransferase levels, requires vasopressor support or suffers from cholestasis (defined as serum bilirubin levels > 5 mg/dL) for 3 sessions again. There will be a maximum of 7 MARS ® sessions per patient.