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000164245 037__ $$aDZNE-2022-00901
000164245 041__ $$aEnglish
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000164245 1001_ $$aAl-Chalabi, Ahmed$$b0
000164245 245__ $$aEvaluation of an ADVanced Organ Support (ADVOS) system in a two-hit porcine model of liver failure plus endotoxemia.
000164245 260__ $$aHeidelberg$$bSpringer Open$$c2017
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000164245 520__ $$aNovel extracorporeal procedures are constantly being developed and evaluated for use in patients with sepsis. Preclinical evaluation of such procedures usually requires testing in large animal models. In the present work, the safety and efficacy of a recently developed ADVanced Organ Support (ADVOS) system in a newly developed large animal two-hit model of liver failure combined with endotoxemia were tested.After establishing the model in more than 50 animals, a randomized study was performed. An inflammatory cholestatic liver injury was initially provoked in pigs. Three days after surgery, endotoxin was gradually administered during 7½ h. Animals were randomized to receive standard medical treatment either with (ADVOS group, n = 5) or without ADVOS (control group, n = 5). The ADVOS treatment was started 2½ h after endotoxemia and continued for 7 h. Survival, cardiovascular, respiratory, renal, liver, coagulation, and cerebral parameters were analyzed.Three days after surgery, cholestatic injury resulted in hyperbilirubinemia [5.0 mg/dl (IQR 4.3-5.9 mg/dl)], hyperammonemia [292 μg/dl (IQR 291-296 μg/dl)], leukocytosis [20.2 103/μl (IQR 17.7-21.8 103/μl)], and hyperfibrinogenemia [713 mg/dl (IQR 654-803 mg/dl)]. After endotoxemia, the ADVOS procedure stabilized cardiovascular, respiratory, and renal parameters and eliminated surrogate markers as bilirubin [2.3 (IQR 2.3-3.0) vs. 5.5 (IQR 4.6-5.6) mg/dl, p = 0.001] and creatinine [1.4 (IQR 1.1-1.7) vs. 2.3 (IQR 2.1-3.1) mg/dl, p = 0.01]. Mortality: All animals in the ADVOS group survived, while all animals in the control group expired during the 10-h observation period (p = 0.002). No adverse events related to the procedure were observed.The ADVOS procedure showed a promising safety and efficacy profile and improved survival in a sepsis-like animal model with dysfunction of multiple organs. An amelioration of major organ functions (heart and lung) combined with removal of markers for kidney and liver function was observed.
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000164245 650_7 $$2Other$$aAlbumin dialysis
000164245 650_7 $$2Other$$aAnimal model
000164245 650_7 $$2Other$$aCholestasis
000164245 650_7 $$2Other$$aEndotoxemia
000164245 650_7 $$2Other$$aExtracorporeal organ support
000164245 650_7 $$2Other$$aLiver failure
000164245 650_7 $$2Other$$aMultiple organ failure
000164245 650_7 $$2Other$$aSepsis
000164245 650_7 $$2Other$$aSurvival
000164245 650_7 $$2Other$$aSwine
000164245 7001_ $$aMatevossian, Edouard$$b1
000164245 7001_ $$0P:(DE-2719)9000925$$avon Thaden, Anne$$b2$$udzne
000164245 7001_ $$aSchreiber, Catherine$$b3
000164245 7001_ $$aRadermacher, Peter$$b4
000164245 7001_ $$aHuber, Wolfgang$$b5
000164245 7001_ $$aPerez Ruiz de Garibay, Aritz$$b6
000164245 7001_ $$aKreymann, Bernhard$$b7
000164245 773__ $$0PERI:(DE-600)2740385-3$$a10.1186/s40635-017-0144-3$$gVol. 5, no. 1, p. 31$$n1$$p31$$tIntensive Care Medicine Experimental$$v5$$x2197-425X$$y2017
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