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pubmed:abstractText |
Ten patients in stage IV hepatic encephalopathy who had not responded to conventional therapy for at least 48 hrs were treated with one or more 4 hr periods of hemoperfusion. Nine (90%) awoke, and 4 (40%) are alive to date, the survivors having acutely toxic and infective hepatic lesions. Biochemical changes that occurred were a reduction in blood ammonia of 23%, a rise in the ratio of branched chain to aromatic amino acids in blood (1.08 +/- 0.3 to 1.3 +/- 0.4), and cerebrospinal fluid (0.26 +/- 0.02 to 0.32 to 0.03), and a rise in cerebrospinal fluid cAMP from 2.3 +/- 0.7 ng/ml to 3.4 +/- 1.29 ng/ml with hemoperfusion. Administration of platelets and fresh frozen plasma restored the reduction of platelet counts of 29% towards pretreatment values.
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