Artificial liver technique in the treatment of severe hyperbilirubinemia after cardiovascular surgery

Liu Hong; Pei Fengbo; Chen Zujun; Liu Ping

doi:10.13498/j.cnki.chin.j.ecc.2023.05.07

Abstract：Objective This study analyzed the effectiveness and safety of therapeutic plasma exchange(TPE)and albumin dialysis combined with bilirubin adsorption in the treatment of severe postoperative hyperbilirubinemia.Methods Between Janu-ary 2012 and December 2020,a total of 13 patients received artificial liver technique due to severe hyperbilirubinemia after sur-gery,including 7 cases of TPE and 6 cases of albumin dialysis combined with bilirubin adsorption.Parameters of pre-and post-treat-ment were compared,including MAP,CVP,inotropic drug score,total bilirubin(TB),conjuncted bilirubin(CB),prothrombin activ-ity(PTA),ALT,AST.The effectiveness of the two treatments were compared.Results TB(516.1±83.3 vs 346.1±53.5,P<0.001),CB(305.1±68.4 vs 212.4±59.8,P<0.001),PTA(49±0.3 vs 61±0.5,P<0.001)of pre-and post-treatment in TPE group had significant differences.TB(511.4±96.5 vs 368.3±76.8,P<0.001),CB(277.2±53.6 vs 198.3±46.7,P<0.001)of pre-and post-treatment in albu-min dialysis combined with bilirubin adsorption group had significant differences.For the improvement of TB(32.9±2.6 vs 27.2±3.7,P&LT;0.001),CB(30.4±2.9 vs 27.1±2.5,P&LT;0.001)and PTA(19.7±1.6 vs 2.8±1.8 P&LT;0.001)in two groups,TPE was better than albumin dialysis combined with bilirubin adsorption.Both treatments had hemodynamic stability,and no other adverse reactions occured.Conclusions TPE and albumin dialysis combined with bilirubin adsorption both are safe and effective treat-ments for severe hyperbilirubinemia after cardiovascular surgery,which should be selected according to the clinical situation.