2014 Volume 5 Issue 1 Pages 25-29
The settings and devices for use in artificial liver support (ALS) of pediatric acute liver failure have not yet been standardized. As a strategy for rapid deployment of ALS for children (5〜30kg), we have devised protocol that we introduced in May 2009. The simple plasma exchange (PE) in acute liver failure is important by not only the removal of the disease create substances but also the supplement of the coagulation factors. We began by examining the prescribed replacement plasma volume (100〜150mL/kg) for simple plasma exchange (PE) in this protocol. We compared the PT-INR and PT activity of seven cases (6.4〜19.3kg) of acute liver failure coma, before and after the first PE. The PT-INR and PT activity in six of the seven cases (86%) showed an improvement by more than 1.5 times and less than 40%, respectively. And no hemorrhagic complication was observed in all cases. The prescribed replacement plasma volume of PE used in this protocol reached a sufficient therapeutic dose for the supplement of the coagulation factors.
