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@ARTICLE{AlChalabi:164245,
      author       = {Al-Chalabi, Ahmed and Matevossian, Edouard and von Thaden,
                      Anne and Schreiber, Catherine and Radermacher, Peter and
                      Huber, Wolfgang and Perez Ruiz de Garibay, Aritz and
                      Kreymann, Bernhard},
      title        = {{E}valuation of an {ADV}anced {O}rgan {S}upport ({ADVOS})
                      system in a two-hit porcine model of liver failure plus
                      endotoxemia.},
      journal      = {Intensive Care Medicine Experimental},
      volume       = {5},
      number       = {1},
      issn         = {2197-425X},
      address      = {Heidelberg},
      publisher    = {Springer Open},
      reportid     = {DZNE-2022-00901},
      pages        = {31},
      year         = {2017},
      abstract     = {Novel 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.},
      keywords     = {Albumin dialysis (Other) / Animal model (Other) /
                      Cholestasis (Other) / Endotoxemia (Other) / Extracorporeal
                      organ support (Other) / Liver failure (Other) / Multiple
                      organ failure (Other) / Sepsis (Other) / Survival (Other) /
                      Swine (Other)},
      cin          = {Animal Facility (Mouse) München},
      ddc          = {610},
      cid          = {I:(DE-2719)1140012},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:28677045},
      pmc          = {pmc:PMC5496922},
      doi          = {10.1186/s40635-017-0144-3},
      url          = {https://pub.dzne.de/record/164245},
}